Surgical Management of Bladder Carcinoma

Rafael Carrion, MD, John Seigne, MB


Cancer Control. 2002;9(4) 

In This Article

Complications of Radical Cystectomy and Urinary Diversion

Radical cystectomy is considered to be a major surgical procedure. As a result, various complications may occur during both the early and late postoperative period ( Table 3 ). It is important to know not only the complications, but also the factors that can increase or decrease the risk for complications following a radical cystectomy. Important preoperative variables include age, sex, American Society of Anesthesiologists score, preoperative hemoglobin, smoking history, prior abdominal surgeries or external-beam radiation therapy, and type of diversion. The patient who has a standard radical cystectomy with ileal conduit or cutaneous ureterostomy usually requires 5 to 7 days of hospitalization, while the patient undergoing continent urinary diversion may require 7 to 10 days of hospitalization. Important intraoperative and postoperative variables include estimated blood loss, operative time, transfusion requirement, pathologic tumor stage, the need for surgical intensive care unit admission, and postoperative hemoglobin level. Overall, the rate of minor complications for patients undergoing radical cystectomy is approximately 30%. The risk for a major complication with this procedure is about 5%, and the mortality rate is approximately 1% to 3%.[45,46,47,48,49]


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