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Current Urology Reports

Erschienen in:

01.04.2015 | Urothelial Cancer (A Sagalowsky, Section Editor)

Preoperative and Modifiable Factors to Lower Postoperative Complications After Radical Cystectomy

verfasst von: Marie C. Hupe, Mario W. Kramer, Axel S. Merseburger

Erschienen in: Current Urology Reports | Ausgabe 4/2015

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Abstract

Radical cystectomy is the gold standard for muscle-invasive bladder cancer. It is a challenging procedure comprising of two steps: removal of the bladder followed by construction of a new urinary diversion. Despite advances in surgical and postoperative management within the last decades, postoperative complication rates for this procedure are still considerably high. Many complications are avoidable in the pre-/intra-/postoperative setting by carefully selecting patients eligible for this procedure and by considering prophylactic measures. Fast-track concepts demonstrate current intentions to optimize perioperative management. This review summarizes the most recent studies and findings on how to lower postoperative complications with the help of preoperative and modifiable factors.

Siegel R, Ma J, Zou Z, Jemal A. Cancer statistics, 2014. CA Cancer J Clin. 2014;64:9–29.CrossRefPubMed

DeSantis CE, Lin CC, Mariotto AB, Siegel RL, Stein KD, Kramer JL, et al. Cancer treatment and survivorship statistics, 2014. CA Cancer J Clin. 2014;64:252–71.CrossRefPubMed

Babjuk M, Burger M, Zigeuner R, Shariat SF, van Rhijn BW, Comperat E, et al. EAU guidelines on non-muscle-invasive urothelial carcinoma of the bladder: update 2013. Eur Urol. 2013;64:639–53.CrossRefPubMed

Witjes JA, Comperat E, Cowan NC, De Santis M, Gakis G, Lebret T, et al. EAU guidelines on muscle-invasive and metastatic bladder cancer: summary of the 2013 guidelines. Eur Urol. 2014;65:778–92.CrossRefPubMed

Hautmann RE, de Petriconi RC, Pfeiffer C, Volkmer BG. Radical cystectomy for urothelial carcinoma of the bladder without neoadjuvant or adjuvant therapy: long-term results in 1100 patients. Eur Urol. 2012;61:1039–47.CrossRefPubMed

Hautmann RE, de Petriconi RC, Volkmer BG. Lessons learned from 1,000 neobladders: the 90-day complication rate. J Urol. 2010;184:990–4. quiz 1235.CrossRefPubMed

Trinh VQ, Trinh QD, Tian Z, Hu JC, Shariat SF, Perrotte P, et al. In-hospital mortality and failure-to-rescue rates after radical cystectomy. BJU Int. 2013;112:E20–7.CrossRefPubMed

Leow JJ, Reese S, Trinh QD, Bellmunt J, Chung BI, Kibel AS, et al. The impact of surgeon volume on the morbidity and costs of radical cystectomy in the United States: a contemporary population-based analysis. BJU Int. 2014. doi:10.1111/bju.12749 [accepted article].

Schiavina R, Borghesi M, Guidi M, Vagnoni V, Zukerman Z, Pultrone C, et al. Perioperative complications and mortality after radical cystectomy when using a standardized reporting methodology. Clin Genitourin Cancer. 2013;11:189–97.CrossRefPubMed

10.

Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240:205–13.CrossRefPubMedCentralPubMed

11.

2nd Martin RC, Brennan MF, Jaques DP. Quality of complication reporting in the surgical literature. Ann Surg. 2002;235:803–13.CrossRefPubMedCentralPubMed

12.

American Society of Anesthesiologists. ASA Physical Status Classification System. https://www.asahq.org/clinical/physicalstatus.htm. Accessed 22 November 2014.

13.

Charlson ME, Pompei P, Ales KL, MacKenzie CR. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis. 1987;40:373–83.CrossRefPubMed

14.

Djaladat H, Bruins HM, Miranda G, Cai J, Skinner EC, Daneshmand S. The association of preoperative serum albumin level and American Society of Anesthesiologists (ASA) score on early complications and survival of patients undergoing radical cystectomy for urothelial bladder cancer. BJU Int. 2014;113:887–93.CrossRefPubMed

15.•

Roghmann F, Trinh QD, Braun K, von Bodman C, Brock M, Noldus J, et al. Standardized assessment of complications in a contemporary series of European patients undergoing radical cystectomy. Int J Urol. 2014;21:143–9. This study depicts contemporary complication and mortality rates following radical cystectomy and urinary diversion by analyzing a cohort of more than 500 patients. It refers to the Clavien-Dindo grading system and to the Martin criteria.CrossRefPubMed

16.

Hollenbeck BK, Miller DC, Taub D, Dunn RL, Khuri SF, Henderson WG, et al. Identifying risk factors for potentially avoidable complications following radical cystectomy. J Urol. 2005;174:1231–7. discussion 1237.CrossRefPubMed

17.

Pietzak EJ, Hwang WT, Malkowicz SB, Guzzo TJ. Factors influencing the length of stay after radical cystectomy: implications for cancer care and perioperative management. Ann Surg Oncol. 2014;21:4383–9.CrossRefPubMed

18.

Novotny V, Zastrow S, Koch R, Wirth MP. Radical cystectomy in patients over 70 years of age: impact of comorbidity on perioperative morbidity and mortality. World J Urol. 2012;30:769–76.CrossRefPubMed

19.

Large MC, Reichard C, Williams JT, Chang C, Prasad S, Leung Y, et al. Incidence, risk factors, and complications of postoperative delirium in elderly patients undergoing radical cystectomy. Urology. 2013;81:123–8.CrossRefPubMed

20.

Donahue TF, Bochner BH, Sfakianos JP, Kent M, Bernstein M, Hilton WM, et al. Risk factors for the development of parastomal hernia after radical cystectomy. J Urol. 2014;191:1708–13.CrossRefPubMedCentralPubMed

21.

Kouba E, Sands M, Lentz A, Wallen E, Pruthi RS. Incidence and risk factors of stomal complications in patients undergoing cystectomy with ileal conduit urinary diversion for bladder cancer. J Urol. 2007;178:950–4.CrossRefPubMed

22.

Prentis JM, Trenell MI, Vasdev N, French R, Dines G, Thorpe A, et al. Impaired cardiopulmonary reserve in an elderly population is related to postoperative morbidity and length of hospital stay after radical cystectomy. BJU Int. 2013;112:E13–9.CrossRefPubMed

23.

Garg T, Chen LY, Kim PH, Zhao PT, Herr HW, Donat SM. Preoperative serum albumin is associated with mortality and complications after radical cystectomy. BJU Int. 2014;113:918–23.CrossRefPubMed

24.

Lambert JW, Ingham M, Gibbs BB, Given RW, Lance RS, Riggs SB. Using preoperative albumin levels as a surrogate marker for outcomes after radical cystectomy for bladder cancer. Urology. 2013;81:587–92.CrossRefPubMed

25.

Gregg JR, Cookson MS, Phillips S, Salem S, Chang SS, Clark PE, et al. Effect of preoperative nutritional deficiency on mortality after radical cystectomy for bladder cancer. J Urol. 2011;185:90–6.CrossRefPubMedCentralPubMed

26.••

Roth B, Birkhauser FD, Zehnder P, Thalmann GN, Huwyler M, Burkhard FC, et al. Parenteral nutrition does not improve postoperative recovery from radical cystectomy: results of a prospective randomised trial. Eur Urol. 2013;63:475–82. This randomized trial compared total parenteral nutrition with oral nutrition alone. Notably, patients receiving total parenteral nutrition had a higher risk for postoperative complications, especially infections.CrossRefPubMed

27.

Large MC, Kiriluk KJ, DeCastro GJ, Patel AR, Prasad S, Jayram G, et al. The impact of mechanical bowel preparation on postoperative complications for patients undergoing cystectomy and urinary diversion. J Urol. 2012;188:1801–5.CrossRefPubMed

28.

Zaid HB, Kaffenberger SD, Chang SS. Improvements in safety and recovery following cystectomy: reassessing the role of pre-operative bowel preparation and interventions to speed return of post-operative bowel function. Curr Urol Rep. 2013;14:78–83.CrossRefPubMed

29.

Hashad MM, Atta M, Elabbady A, Elfiky S, Khattab A, Kotb A. Safety of no bowel preparation before ileal urinary diversion. BJU Int. 2012;110:E1109–13.CrossRefPubMed

30.

Raynor MC, Lavien G, Nielsen M, Wallen EM, Pruthi RS. Elimination of preoperative mechanical bowel preparation in patients undergoing cystectomy and urinary diversion. Urol Oncol. 2013;31:32–5.CrossRefPubMed

31.••

Lee CT, Chang SS, Kamat AM, Amiel G, Beard TL, Fergany A, et al. Alvimopan accelerates gastrointestinal recovery after radical cystectomy: a multicenter randomized placebo-controlled trial. Eur Urol. 2014;66:265–72. This randomized trial evaluated the peripheral μ-opioid receptor antagonist Alvimopan with regard to bowel recovery after radical cystectomy. Time to bowel recovery was shorter in the Alvimopan group compared to the placebo group.CrossRefPubMed

32.

Wuethrich PY, Burkhard FC, Thalmann GN, Stueber F, Studer UE. Restrictive deferred hydration combined with preemptive norepinephrine infusion during radical cystectomy reduces postoperative complications and hospitalization time: a randomized clinical trial. Anesthesiology. 2014;120:365–77.CrossRefPubMed

33.

Pillai P, McEleavy I, Gaughan M, Snowden C, Nesbitt I, Durkan G, et al. A double-blind randomized controlled clinical trial to assess the effect of Doppler optimized intraoperative fluid management on outcome following radical cystectomy. J Urol. 2011;186:2201–6.CrossRefPubMed

34.

Wolf Jr JS, Bennett CJ, Dmochowski RR, Hollenbeck BK, Pearle MS, Schaeffer AJ, et al. Best practice policy statement on urologic surgery antimicrobial prophylaxis. J Urol. 2008;179:1379–90.CrossRefPubMed

35.

Hara N, Kitamura Y, Saito T, Komatsubara S, Nishiyama T, Takahashi K. Perioperative antibiotics in radical cystectomy with ileal conduit urinary diversion: efficacy and risk of antimicrobial prophylaxis on the operation day alone. Int J Urol. 2008;15:511–5.CrossRefPubMed

36.

Clement C, Rossi P, Aissi K, Barthelemy P, Guibert N, Auquier P, et al. Incidence, risk profile and morphological pattern of lower extremity venous thromboembolism after urological cancer surgery. J Urol. 2011;186:2293–7.CrossRefPubMed

37.

Forrest JB, Clemens JQ, Finamore P, Leveillee R, Lippert M, Pisters L, et al. AUA best practice statement for the prevention of deep vein thrombosis in patients undergoing urologic surgery. J Urol. 2009;181:1170–7.CrossRefPubMed

38.

S3-Leitlinie Prophylaxe der Venösen Thromboembolie (VTE). Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften e.V. (AWMF). http://www.awmf.org/uploads/tx_szleitlinien/003-001_S3_AWMF-Leitlinie_Prophylaxe_der_venoesen_Thromboembolie__VTE__Kurz_2009.pdf. Accessed 22 November 2014.

39.

Karl A, Seitz M, Staehler M, Becker A, Weninger E, Rittler P, et al. Fast track approach in radical cystectomy. Urologe A. 2011;50:1072–5.CrossRefPubMed

40.

Pruthi RS, Nielsen M, Smith A, Nix J, Schultz H, Wallen EM. Fast track program in patients undergoing radical cystectomy: results in 362 consecutive patients. J Am Coll Surg. 2010;210:93–9.CrossRefPubMed

41.

Saar M, Ohlmann CH, Siemer S, Lehmann J, Becker F, Stockle M, et al. Fast-track rehabilitation after robot-assisted laparoscopic cystectomy accelerates postoperative recovery. BJU Int. 2013;112:E99–E106.CrossRefPubMed

42.•

Smith J, Meng ZW, Lockyer R, Dudderidge T, McGrath J, Hayes M, et al. Evolution of the Southampton enhanced recovery programme for radical cystectomy and the aggregation of marginal gains. BJU Int. 2014;114:375–83. This retrospective analysis shows that interactive features in the preoperative and postoperative setting such as nurse teaching programs, patient education and an increased surgeon-patient contact can significantly decrease the length of hospital stay.CrossRefPubMed

Titel: Preoperative and Modifiable Factors to Lower Postoperative Complications After Radical Cystectomy
verfasst von: Marie C. Hupe
Mario W. Kramer
Axel S. Merseburger
Publikationsdatum: 01.04.2015
Verlag: Springer US
Erschienen in: Current Urology Reports / Ausgabe 4/2015
Print ISSN: 1527-2737
Elektronische ISSN: 1534-6285
DOI: https://doi.org/10.1007/s11934-015-0493-y

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Preoperative and Modifiable Factors to Lower Postoperative Complications After Radical Cystectomy

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