How to lower postoperative complications after radical cystectomy - a review

Abstract

IntroductionLowering morbidity and mortality after RC is subject of considerable interest. Lately, many evidence-based data on improvements in operative technique, anesthetic management, and patient care have been published.In this article, we present a review of literature on how to lower postoperative complications after RC.Material and methodsThe Medline, and Web of Science databases were searched without a time limit on February 2016 using the terms ‘cystectomy’ in conjunction with ‘radical’, ‘bladder cancer’, ‘complications’ or ‘management’. Boolean operators (NOT, AND, OR) were also used in succession to narrow and broaden the search. The search was limited to the English, Polish and Spanish literature.ResultsMany complications may be avoided by appropriate patient selection and meticulous introduction of care protocols.ConclusionsRC as treatment free of complications, even in the hands of an experienced urologist, does not exist. A large number of complications are acceptable in the name of good long-term results. Optimum results are possible with proper surgical technique, good patients and urinary diversion selection and proper patient management in the pre-, peri, and postoperative period.

EffectiveNess of a multimodal preHAbilitation program in patieNts with bladder canCEr undergoing radical cystectomy: protocol of the ENHANCE multicentre randomised controlled trial

“…Patients with bladder cancer will be followed for a period of 90 days after surgery, meaning that longer-term evaluation of outcomes will not be possible. Because up to 60% of patients-report complications within 90 days after surgery, 71 it is expected that the time frame will be adequate for our primary outcome. A possible limitation is the risk of contamination in the control group.…”

Choice of urine derivation method after radical cystectomy in the high anesthesiological risk group

“…Выживаемость пациентов после радикальной цистэктомии имеет обратную корреляцию с выраженностью экстраренальной патологии [18]. У большинства пациентов с осложнениями уротелиального мышечно-инвазивного РМП и выраженной сопутствующей кардиопульмональной патологией, иммунодефицитом, осложненным сахарным диабетом или заболеваниями желудочно-кишечного тракта, не позволяющими использовать сегмент кишки для деривации мочи, выполнение уретерокутанеостомии может являться предпочтительным вариантом отведения мочи после радикальной цистэктомии [19]. По данным ряда авторов, проведение перекрестной уретероуретеростомии и формирование односторонней уретерокутанеостомы не повышают частоту ранних послеоперационных ОНКОУРОЛОГИЯ 1'2020 ТОм 16 CANCER UROLOGY 1'2020 VOL.…”