title: Standardized analysis of complications after robot-assisted radical cystectomy: Korea University Hospital experience.
abstract: OBJECTIVE
  To analyze the complications after robot-assisted radical cystectomy (RARC) by use of a standardized reporting methodology by a single surgeon.
  
  
  METHODS
  We prospectively reviewed a maintained institutional database of 52 patients who underwent RARC to manage bladder cancer and were followed up in 3 months by a single surgeon at Korea University Medical Center from 2007 through 2014. All complications within 90 days of surgery were defined and categorized into 5 grades according to the Clavien-Dindo classification. Logistic regression analysis was used to identify predictors of complications.
  
  
  RESULTS
  Fifty percent of patients (26 of 52) experienced a complication of any grade <90 days after surgery, and 11 patients (21.2%) experienced a major complication. Complications were grouped in systems-based categories. Fifty complications occurred in 52 patients and hematologic complication (transfusion) was the most common (13 of 52). Wound dehiscence, anastomotic leakage, urinary tract obstruction, mechanical obstruction, and thromboembolism occurred as major complications. Mean estimated blood loss (EBL) was 247 mL and mean total operative time was 496 minutes. The mean number of lymph nodes harvested was 24.6, with 30.5 for extended dissection. EBL (over 300 mL), operative time, and method of urinary diversion were significant negative predictors of minor complications, whereas EBL (over 300 mL) was a significant negative predictor of major complications (p<0.05).
  
  
  CONCLUSIONS
  The present results show that the complication rate reported by use of a standardized methodology after robotic radical cystectomy is still considerable although comparable to that of contemporary robot series. EBL, operative time, and diversion methods were predictors of complications.
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jong Hyun
authors.initials: JH
authors.lastname: Pyun
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Hyung Keun
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jae Yoon
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seung Bin
authors.initials: SB
authors.lastname: Kim
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seok
authors.initials: S
authors.lastname: Cho
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Sung Gu
authors.initials: SG
authors.lastname: Kang
authors.affiliation: Department of Urology, Yeungnam University College of Medicine, Daegu, Korea.
authors.forename: Young Hwii
authors.initials: YH
authors.lastname: Ko
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jun
authors.initials: J
authors.lastname: Cheon
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Jeong Gu
authors.initials: JG
authors.lastname: Lee
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Je Jong
authors.initials: JJ
authors.lastname: Kim
authors.affiliation: Department of Urology, Korea University College of Medicine, Seoul, Korea.
authors.forename: Seok Ho
authors.initials: SH
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D057868:Anastomotic Leak; D016063:Blood Loss, Surgical; D015653:Cystectomy / Q000009:adverse effects*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D016015:Logistic Models; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011183:Postoperative Complications; D011446:Prospective Studies; D056910:Republic of Korea; D012307:Risk Factors; D065287:Robotic Surgical Procedures; D013529:Surgical Wound Dehiscence; D013923:Thromboembolism; D016896:Treatment Outcome; D001743:Urinary Bladder / Q000473:pathology; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects*
keywords: Cystectomy; Postoperative complication; Robotics; Urinary diversion