title: [The analysis of perioperative complications during radical cystectomy using a standardized reporting system].
abstract: OBJECTIVE
  To analyze the perioperative complications of radical cystectomy using a standardized reporting methodology.
  
  
  METHODS
  The clinical data of 233 cases of radical cystectomy from January 1996 to December 2008 were reviewed. Two hundred male patients and 33 female patients were included. The mean age was 58.9 years old. All complications within 30 days of surgery were recorded and classified using a 5-grade modification of the Clavien system.
  
  
  RESULTS
  Overall mean operative time was 339 (170 - 610) minutes, and mean blood loss was 818 (range 100 to 3500) ml. Of the 233 subjects at least 1 postoperative complication developed in 84 (36.1%), including five cases of intraoperative complications. According to the modified Clavien system, 27 patients (11.6%) had grade 1, 38(16.3%) had grade 2, 16(6.9%) had grade 3, and 3(1.7%) had grade 4 complications. The most frequent complication was gastrointestinal complications (15.9%), then the incision-related complications (15.0%) and lung infections (4.7%). An association between hypoproteinemia and any complication was found after adjusting for confounding variables (OR = 2.963, 95%CI: 1.451 - 6.050, P = 0.003), and American society of anesthesia score (ASA score) was significantly associated with any major complication (OR = 2.520, 95%CI: 1.003 - 6.332, P = 0.049).
  
  
  CONCLUSIONS
  Radical cystectomy is associated with a high perioperative complications, using the modification of the Clavien system has allowed us to stratify complications during radical cystectomy. Hypoproteinemia is independently associated with any complication in these patients and ASA score was significantly associated with any major complication.
authors.affiliation: Department of Urology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
authors.forename: Sheng-zheng
authors.initials: SZ
authors.lastname: Wang
authors.forename: Ling-wu
authors.initials: LW
authors.lastname: Chen
authors.forename: Huan-yi
authors.initials: HY
authors.lastname: Lin
authors.forename: Wen-wei
authors.initials: WW
authors.lastname: Wang
authors.forename: Jun-xing
authors.initials: JX
authors.lastname: Chen
mesh_terms: D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000145:classification* / Q000453:epidemiology; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000601:surgery*