title: Analysis of early complications of robotic-assisted radical cystectomy using a standardized reporting system.
abstract: OBJECTIVE
  To analyze the early complications of robotic-assisted laparoscopic radical cystectomy (RARC) with extracorporeal ileal conduit or orthotopic (Studer) bladder reconstruction using the Clavien Classification, the management of these complications, and possible preventive measures.
  
  
  METHODS
  Detailed data on all patients undergoing RARC were recorded prospectively on an encrypted database, including intraoperative or postoperative complications within 90 days of surgery. Outcome data during follow-up of up to 4 years was also collected prospectively.
  
  
  RESULTS
  A total of 50 patients (M:F 44:6) underwent RARC and extracorporeal ileal conduit urinary diversion (n = 45) or orthotopic bladder reconstruction (n = 5) between 2004 and 2008. The overall perioperative complication rate was 17 of 50 (34%), including 3 (6%) Clavien I, 9 (18%) Clavien II, and 5 (10%) Clavien III. Final histology showed 9 (18%) patients had no residual disease pT0, 7 (14%) pTa, 11 (22%) pT1, 9 (18%) pT2, 11 (22%) pT3, and 3 (6%) pT4.
  
  
  CONCLUSIONS
  Radical cystectomy remains a complex and morbid procedure with significant complication rate regardless of surgical approach. Using the Clavien reporting system, we identified early complications in 34% of patients, of which five required a significant intervention. Use of this standardized reporting system has allowed us to stratify complications after RARC, allowing easy comparison to other techniques and targeting further reductions in the future.
authors.affiliation: Department of Urology, Guy's Hospital, King's Health Partners AHSC, London, United Kingdom.
authors.forename: Muhammad Shamim
authors.initials: MS
authors.lastname: Khan
authors.forename: Oussama
authors.initials: O
authors.lastname: Elhage
authors.forename: Ben
authors.initials: B
authors.lastname: Challacombe
authors.forename: Peter
authors.initials: P
authors.lastname: Rimington
authors.forename: Declan
authors.initials: D
authors.lastname: Murphy
authors.forename: Prokar
authors.initials: P
authors.lastname: Dasgupta
mesh_terms: D000328:Adult; D000368:Aged; D015653:Cystectomy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification / Q000453:epidemiology / Q000209:etiology; D011446:Prospective Studies; D012371:Robotics; D013997:Time Factors