title: Perioperative complications of radical cystectomy in a contemporary series.
abstract: OBJECTIVE
  Radical cystectomy is the preferred standard treatment for patients with muscle-invasive bladder cancer. With improvements in intra- and perioperative care lower complication rates have been reported. We retrospectively evaluated our series of patients who underwent radical cystectomy for advanced bladder cancer for perioperative complications as well as operative time, postoperative hospital stay and transfusion rates.
  
  
  METHODS
  Between April 1993 and August 2005, 516 radical cystectomies were performed for muscle infiltrating transitional cell carcinoma and other types of neoplastic diseases of the bladder at our institution. The average age was 66.3 yr (31-89).
  
  
  RESULTS
  The perioperative mortality rate was 0.8%. A total of 141 patients (27.3%) developed at least one perioperative complication. The most frequent medical complications were subileus in 20 (3.9%) patients, deep venous thrombosis in 24 (4.7%), and enterocolitis in 10 (1.9%). Surgical complications included pelvic lymphoceles in 42 (8.1%) patients, wound dehiscence in 46 (8.9%), pelvic hematoma in 4 (0.8%), peritonitis in 4 (0.8%) and small bowel obstruction in 4 (0.8%). The total early reoperation rate was 6.2%. Operative time, postoperative hospital stay and average number of blood units transfused decreased over the period 1993-2005.
  
  
  CONCLUSIONS
  Radical cystectomy today is a procedure with an acceptable rate of perioperative morbidity and mortality. Improvements in surgical technique and anaesthesia as well as increased quality of perioperative care in recent years have resulted in reduced morbidity and shorter hospital stay.
authors.affiliation: Department of Urology, Technical University, Dresden, Germany. Vladimir.Novotny@uniklinikum-dresden.de <Vladimir.Novotny@uniklinikum-dresden.de>
authors.forename: Vladimir
authors.initials: V
authors.lastname: Novotny
authors.forename: Oliver W
authors.initials: OW
authors.lastname: Hakenberg
authors.forename: Diana
authors.initials: D
authors.lastname: Wiessner
authors.forename: Ulrike
authors.initials: U
authors.lastname: Heberling
authors.forename: Rainer J
authors.initials: RJ
authors.lastname: Litz
authors.forename: Sven
authors.initials: S
authors.lastname: Oehlschlaeger
authors.forename: Manfred P
authors.initials: MP
authors.lastname: Wirth
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000601:surgery*; D015653:Cystectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000601:surgery*