title: Surgical complications of radical cystectomy in a teaching hospital.
abstract: We reviewed the surgical complications in 112 consecutive patients who had undergone radical cystectomy for bladder cancer at Tygerberg Hospital between 1978 and 1989. The cystectomies were performed by a total of 16 surgeons, of whom 1 (A) performed 30 and assisted at 2, 1 (B) performed 26 and assisted at 4, 2 (C + D) performed 27 and assisted at 16, and 12 (E-P) performed 29 and assisted at 46. Pre-operative radiotherapy was given in 37% of cases and intravesical chemotherapy in 25%. Major coexisting medical problems were present in 60%. The overall peri-operative mortality rate was 11%, but the rate was significantly lower (3%) in the group of patients operated on by surgeon A than in those operated on by surgeons E-P (21%). Major early postoperative complications occurred in 17% of the patients and major late complications in 25%. There were no significant differences between the different surgical groups in early and late complication rates. Peri-operative mortality and major early complications were significantly increased in patients aged over 71 years compared with those aged under 60 years. Peri-operative mortality was significantly increased in patients who had not received pre-operative radiotherapy compared with those who had done so. The presence of major coexistent medical problems did not significantly affect the rates of peri-operative mortality or major early or late surgical complications. Peri-operative mortality was lower in patients with T0-1 tumours than in those with T2-4 tumours, but the stage did not affect the incidence of major early or late surgical complications.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Urology, University of Stellenbosch, W. Cape.
authors.forename: J W
authors.initials: JW
authors.lastname: Aucamp
authors.forename: C F
authors.initials: CF
authors.lastname: Heyns
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002983:Clinical Competence; D015986:Confounding Factors, Epidemiologic; D015653:Cystectomy / Q000401:mortality; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D013019:South Africa; D001743:Urinary Bladder / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000601:surgery