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Single staff cystectomy in a low-volume center: Oncological outcomes and complications.
- Source :
-
Canadian Urological Association Journal . Nov2021, Vol. 15 Issue 11, pe582-E587. 6p. - Publication Year :
- 2021
-
Abstract
- Introduction: Radical cystectomy (RC) with bilateral pelvic lymph node dissection (PLND) is a complex surgical procedure, associated with substantial perioperative complications. Previous studies suggested reserving it to high-volume centers in order to improve oncological and perioperative outcomes. However, only limited data exist regarding low-volume centers with highly experienced surgeons. We aimed to assess oncological and perioperative outcomes after RC performed by experienced surgeons in the lowvolume center of Luzerner Kantonsspital, Lucerne, CH. Methods: We retrospectively analyzed the data of 158 patients who underwent RC and PLND performed between 2009 and 2019 at a single low-volume center by three experienced surgeons, each having performed at least 50 RCs. Complications were graded according to the 2004 modified Clavien-Dindo grading system. Results: A total of 110 patients (70%) received an incontinent urinary diversion (ileal conduit or ureterocutaneostomy) and 48 patients (30%) received a continent urinary diversion (ileal orthotopic neobladder, ureterosigmoidostomy, or Mitrofanoff pouch). Median operating time was 419 minutes (interquartile range [IQR] 346-461). Overall, at RC specimen, 71.5% of patients had urothelial carcinoma ,12.6% squamous, 3.1% sarcomatoid, 1.2% glandular, and 0.6% small cell carcinoma. Median number of lymph nodes removed was 23 (IQR 16-29.5). Positive margins were found in eight patients (5.1%). Overall five-year survival rate was 52.4%. The complication rate was 56.3%: 143 complications were found in 89 patients, 36 (22.8%) with Clavien =3. The 30-day mortality rate was 2.5%. Conclusions: RC could be safely performed in a low-volume center by experienced surgeons with comparable outcomes to highvolume centers. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 19116470
- Volume :
- 15
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- Canadian Urological Association Journal
- Publication Type :
- Academic Journal
- Accession number :
- 153391146
- Full Text :
- https://doi.org/10.5489/cuaj.7171