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International Journal of Urology
Article . 2022 . Peer-reviewed
License: Wiley Online Library User Agreement
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Predicting factor analysis of postoperative complications after robot‐assisted radical cystectomy: Multicenter KORARC database study

Authors: Hwanik Kim; Byong Chang Jeong; Sangchul Lee; Ja Hyeon Ku; Tae Gyun Kwon; Tae‑Hwan Kim; Seung Hyun Jeon; +15 Authors

Predicting factor analysis of postoperative complications after robot‐assisted radical cystectomy: Multicenter KORARC database study

Abstract

ObjectivesTo evaluate postoperative complications following robot‐assisted radical cystectomy in patients diagnosed with bladder cancer and reveal if there are predictors for postoperative complications.MethodsProspectively collected medical records of 730 robot‐assisted radical cystectomy patients between 2007/04 and 2019/05 in 13 tertiary referral centers were reviewed. Perioperative outcomes were compared between two groups by postoperative complications (complication vs non‐complication). We assessed recurrence‐free survival, cancer‐specific survival, and overall survival between groups. Regression analyses were implemented to identify factors associated with postoperative complications.ResultsAny total and high‐grade complication (Clavien–Dindo grade ≥3) rates were 57.8% and 21.1%, respectively. Patients in complication group had significantly higher proportion of diabetes mellitus (P = 0.048), chronic kidney disease (P = 0.011), dyslipidemia (P < 0.001), longer operation time (P = 0.001), more estimated blood loss (P = 0.001), and larger intraoperative fluid volume (P < 0.001). There was a significant difference in cancer‐specific survival (log‐rank P = 0.038, median cancer‐specific survival: both groups not reached). Dyslipidemia (odds ratio 2.59, P = 0.002) and intraoperative fluid volume (odds ratio 1.0002, P = 0.040) were significantly associated with high‐grade postoperative complications. Diabetes mellitus (odds ratio 1.97, P = 0.028), chronic kidney disease (odds ratio 1.89, P = 0.046), dyslipidemia (odds ratio 5.94, P = 0.007), and intraoperative fluid volume (odds ratio 1.0002, P = 0.009) were significantly associated with any postoperative complications.ConclusionsPatients with diabetes mellitus, chronic kidney disease, dyslipidemia, or a relatively large intraoperatively infused fluid volume are more likely to develop postoperative complications. Patients with postoperative complications might have a possibility of lower cancer‐specific survival rate.

Keywords

Postoperative Complications / etiology, 610, Cystectomy, Postoperative Complications / surgery, Postoperative Complications, Robotic Surgical Procedures, postoperative complications, robotic surgical procedures, Humans, Renal Insufficiency, Chronic* / etiology, Renal Insufficiency, Chronic, radical cystectomy, Retrospective Studies, Robotic Surgical Procedures* / adverse effects, Robotics, Statistical, Urinary Bladder Neoplasms*, minimally invasive surgical procedures, Treatment Outcome, Postoperative Complications / epidemiology, Robotics*, Urinary Bladder Neoplasms, bladder cancer, Cystectomy / adverse effects, Factor Analysis, Statistical, Factor Analysis

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
6
Top 10%
Average
Top 10%
Green
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