Defining the association between the prolonged operative time and 90-day complications in patients undergoing radical cystectomy  

作　　者：Peter Hanna Joseph Zabell Badrinath Konety Christopher Warlick 

机构地区：[1]Department of Urology,University of Minnesota,Minneapolis,MN,USA [2]Department of Urology,Aswan University,Aswan,Egypt [3]Department of Urology,Rush University,Chicago,IL,USA

出　　处：《Asian Journal of Urology》2024年第3期429-436,共8页亚洲泌尿外科杂志（英文）

基　　金：Earlier version of this article was presented as a poster in the bladder section:invasive(MP 13-12)AUA-2021.

摘　　要：Objective:Radical cystectomy is a complex lengthy procedure associated with postoperative morbidity.We aimed to assess the operative time(OT)in patients undergoing radical cystectomy and its impact on 90-day postoperative complications and readmission rates.Methods:The retrospective cohort study included 296 patients undergoing radical cystectomy and urinary diversion from May 2010 to December 2018 in our institution.The OT of 369 min was set as a cutoff value between short and long OT groups.The primary outcome was 90-day postoperative complication rates.Secondary outcomes were gastrointestinal recovery time,length of hospital stay,and 90-day readmission rates.Results:The overall incidence of 90-day postoperative complications was 79.7%where 43.2%representing low-grade complications according to the ClavieneDindo classification(Grade 1 and Grade 2),and 36.5%representing high-grade complications(Grade3).Gastrointestinal tract and infectious complications are the most common complications in our data set(45.9%and 45.6%,respectively).On multivariable analysis,prolonged OT was significantly associated with odds of high-grade complications(odds ratio 2.340,95%confidence interval 1.288e4.250,p=0.005).After propensity score-matched analysis,a higher incidence of major complications was identified in the long OT group 55(51.4%)compared to 35(32.7%)in the short OT group(p=0.006).A shorter gastrointestinal tract recovery time was noticed in the short OT group(p=0.009).Prolonged OT was associated with a higher 90-day readmission rate on univariate and multivariate analyses(p<0.001,p=0.001,respectively).

关 键 词：Radical cystectomy Operative time COMPLICATION READMISSION 

分 类 号：R699.5[医药卫生—泌尿科学]