Urinary tract infections following radical cystectomy with enhanced recovery protocol: A prospective study

Ghoreifi, Alireza; Horn, Christine M. Van; Xu, Willem; Cai, Jie; Miranda, Gus; Bhanvadia, Sumeet; Schuckman, Anne; Daneshmand, Siamak; Djaladat, Hooman

doi:10.1016/j.urolonc.2019.12.021

Cited by 22 publications

(33 citation statements)

References 26 publications

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“…Most often UTIs occur before stent removal, and their higher frequency in the early vs. late post-operative period also suggests an important role of these foreign bodies in UTI pathogenesis. Antibiotic treatment should be directed to cultured microorganisms as soon as possible [11][12][13] .…”

Section: Urinary Tract Infectionmentioning

confidence: 99%

Urinary diversions for radical cystectomy: a review of complications and their management

Tinoco¹,

Lima²

2021

MIS

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Radical cystectomy involves a urinary diversion, the most used being the ileal conduit and the orthotopic neobladder. This review focuses on the complications associated with these procedures, dividing them into general and diversion related complications, as well as their management. We conducted a search on PubMed and Scopus to identify eligible articles on complications of urinary diversions. Randomized controlled trials and systematic reviews with meta-analysis were preferred when available. Early complications occur in the first 90 days after surgery. The most common is post-operative ileus, followed by urinary tract infections and urinary leakage. Most complications occur in the late post-operative setting, being related to the type of urinary diversion. Some of these complications are renal failure, metabolic abnormalities, infections, urolithiasis, and ureteroenteric strictures, each with particular management options. Specific ileal conduit complications are conduit deformities and parastomal hernias. Neobladder patients can have continence problems, like incontinence or urinary retention, but also fistulas and dehiscence. Standardization of complications' definitions and time-dependent reporting are crucial to better understand and manage these complications. Complication rates are similar between open and robot-assisted procedures and between intracorporeal and extracorporeal diversion. Radical cystectomy with urinary diversion is the most difficult surgical procedure in urology with high early and late complication rates. There is an urgent need of standardizing complication reporting to better compare different procedures.

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Section: Urinary Tract Infectionmentioning

confidence: 99%

Urinary diversions for radical cystectomy: a review of complications and their management

Tinoco¹,

Lima²

2021

MIS

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“…UTI occurs in up to 36% of patients after RC, especially with the presence of hydronephrosis and/or ureteroileal strictures, and chronic UTIs have been associated with deterioration of renal functions after RC. 16,30 This highlights the importance of regular follow-up for early detection and management of postoperative complications. pN+ve may be attributed to stricture formation and hydronephrosis.…”

Section: Nomogram Predicting Ckd After Rarc 951mentioning

confidence: 99%

Development and Cross-Validation of a Nomogram for Chronic Kidney Disease Following Robot-Assisted Radical Cystectomy

Elsayed

Jing

Demirbas

et al. 2020

Journal of Endourology

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Introduction: We sought to identify the factors associated with deterioration of renal functions after robotassisted radical cystectomy, and to develop a nomogram to detect the probability of progression to chronic kidney disease (CKD). Materials and Methods: A retrospective review of our prospectively maintained database. Estimated glomerular filtration rate (eGFR) was calculated using the CKD-Epidemiology Collaboration creatinine formula utilizing all follow-up creatinine values. CKD was defined as stage 3b (eGFR <45 mL/minute/1.73 m 2) based on the National Kidney Foundation classification. Kaplan-Meier curves were used to depict CKD-free survival. A multivariate Cox regression model was used to determine predictors for CKD and to build the perioperative nomogram. Results: The data set comprised 442 patients with a median follow-up of 25 months (12-59). Thirty-seven percent developed CKD at a median of 9 months (4-18

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“…Bei bis zur Hälfte aller Patienten nach radikaler Zystektomie treten im perioperativen Verlauf Infektionen auf [12][13][14][15][16]. Vornehmlich handelt es sich dabei um Harnwegsinfektionen, die häufig mit einer begleitenden Bakteriämie oder sogar einer Sepsis einhergehen können.…”

Section: Harnwegsinfektionen Und Sepsisunclassified

“…In den vergangenen Jahren konnten eine ganze Reihe unterschiedlicher Risikofaktoren für das Auftreten postoperativer Harnwegsinfektionen identifiziert werden. Dazu gehören neben Alter, Übergewicht und Vorerkrankungen [12,13] auch die Anlage einer orthotopen Harnableitung [14,15,17]. In vielen Fällen sind die entsprechenden Infektionen durch Enterokokken bedingt, sodass eine antibiotische Therapie mit einem erweiterten Wirkungsspektrum erforderlich ist (z.…”

Section: Harnwegsinfektionen Und Sepsisunclassified

Blasenkarzinom − Komplikationen der Harnableitung

Pfister

Niegisch

2020

Aktuelle Urol

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ZusammenfassungAuch heute noch stellt die radikale Zystektomie mit Anlage einer Harnableitung einen der komplikationsträchtigsten Eingriffe in der Uro-Onkologie dar. Insbesondere im Langzeitverlauf, aber auch perioperativ spielen dabei durch die Harnableitung bedingte Probleme eine wesentliche Rolle.Perioperativ stehen dabei im Wesentlichen gastrointestinale Probleme wie etwa ein Ileus, aber auch Infekte und frühe Komplikationen der unterschiedlichen Anastomosen im Vordergrund. Während ein Ileus ebenso wie perioperative Infekte i. d. R. medikamentös behandelt werden können, erfordern Insuffizienzen der intestinalen Anastomose regelhaft und Insuffizienzen der ureterointestinalen Anastomosen häufig operative Revisionen.Im Langzeitverlauf können Narbenbildungen zu chronischen Harnabflussbehinderungen und bei kontinenten Harnableitungen zur Steinbildung führen und ebenso wie parastomale Hernien weitere Therapien erforderlich machen. Funktionelle Darmprobleme können die Lebensqualität der Patienten nachhaltig beeinflussen.Durch eine verbesserte Vorbereitung präoperativ und die begleitenden Maßnahmen während des stationären Aufenthalts können nicht operationsbedingte Komplikationen signifikant reduziert werden.Die Zystektomie mit der therapieassoziierten Morbidität ist ein Paradebeispiel für eine zentrumsbasierte Operation um Komplikationen sowohl perioperativ als auch im weiteren Follow-up zu reduzieren.

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Urinary tract infections following radical cystectomy with enhanced recovery protocol: A prospective study

Cited by 22 publications

References 26 publications

Urinary diversions for radical cystectomy: a review of complications and their management

Urinary diversions for radical cystectomy: a review of complications and their management

Development and Cross-Validation of a Nomogram for Chronic Kidney Disease Following Robot-Assisted Radical Cystectomy

Blasenkarzinom − Komplikationen der Harnableitung

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