title: Grading complication following radical cystectomy and ileal conduit for bladder cancer using Clavien grading system.
abstract: OBJECTIVE
  To determine the 30-day complication rate of radical cystectomy and urinary diversion using a validated system.
  
  
  METHODS
  An analytical descriptive study.
  
  
  METHODS
  The Aga Khan University Hospital, Karachi, from 1990 to 2010.
  
  
  METHODS
  Patients who had undergone ileal conduit (IC) formation, following radical cystectomy (RC) for muscle invasive transitional cell carcinoma, were studied, using a prospectively maintained data base. Basic details were determined, complications were noted and graded according to the modified Clavien grading system (CG). Results were presented using descriptive statistics.
  
  
  RESULTS
  Of all the RC performed at this hospital 89 patients received IC. Of them 75 were male and 14 female. Mean age was 60 years. Mean duration of hospital stay was 14 days. Ten patients each received pre-operative chemotherapy and radiotherapy, respectively. Mean duration of surgery was 8.2 hours, with mean estimated blood loss of 1334 ml. Preoperative radiotherapy was associated with more complications. No other factor like ASA, co-morbidities, blood loss or duration of stay influenced the complications. Fifty patients (56.2%) did not have any complications. Most common complication of wound infection was seen in 7 patients (CG-2), followed by uretero-ileal leakage in 5, requiring percutaneous intervention under local anaesthesia (GC-3a). Mortality rate was 4.5%, classified as CG-V.
  
  
  CONCLUSIONS
  Radical cystectomy with Ileal conduit is a major procedure with a good safety profile at this institute. Longterm follow up is still needed to evaluate delayed complications and quality of life.
authors: Department of Urology/Surgery, The Aga Khan University Hospital, Karachi, Pakistan.
authors: Syed Johar
authors: SJ
authors: Raza
authors: M Hammad
authors: MH
authors: Ather
authors: Faisal Aziz
authors: FA
authors: Khan
authors: Zaheer
authors: Z
authors: Alam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D015897:Comorbidity; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010154:Pakistan / Q000453:epidemiology; D011183:Postoperative Complications; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000453:epidemiology / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*