Surgical Avoidance and Management of Operative Complications

Chapter

Abstract

Open radical cystectomy is associated with overall complication rates approaching 70 % when utilizing strict reporting criteria. There is increasing popularity in the use of robotic assistance when performing radical cystectomy with the goal of decreasing patient morbidity through minimally invasive surgery. In this chapter, we will briefly review perioperative and postoperative outcomes while focusing on the avoidance and management of complications during robot-assisted radical cystectomy.

Keywords

Magnesium Ischemia Citrate Heparin Ileal 

References

  1. 1.
    Shabsigh A, Korets R, Vora KC, et al. Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. Eur Urol. 2009;55(1):164–74.PubMedCrossRefGoogle Scholar
  2. 2.
    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(2):205–13.PubMedCrossRefGoogle Scholar
  3. 3.
    Kauffman EC, Ng CK, Lee MM, et al. Critical analysis of complications after robotic-assisted radical cystectomy with identification of preoperative and operative risk factors. BJU Int. 2010;105(4):520–7.PubMedCrossRefGoogle Scholar
  4. 4.
    Treiyer A, Saar M, Kopper B, Kamradt J, Siemer S, Stockle M. [Robotic-assisted laparoscopic radical cystectomy: evaluation of functional and oncological results]. Actas Urol Esp. 2011;35(3):152–7.PubMedCrossRefGoogle Scholar
  5. 5.
    Khan MS, Elhage O, Challacombe B, Rimington P, Murphy D, Dasgupta P. Analysis of early complications of robotic-assisted radical cystectomy using a standardized reporting system. Urology. 2011;77(2):357–62.PubMedCrossRefGoogle Scholar
  6. 6.
    Hayn MH, Hellenthal NJ, Hussain A, Stegemann AP, Guru KA. Defining morbidity of robot-assisted radical cystectomy using a standardized reporting methodology. Eur Urol. 2011;59(2):213–8.PubMedCrossRefGoogle Scholar
  7. 7.
    Kang SG, Kang SH, Lee YG, et al. Robot-assisted radical cystectomy and pelvic lymph node dissection: a multi-institutional study from Korea. J Endourol. 2010;24(9):1435–40.PubMedCrossRefGoogle Scholar
  8. 8.
    Smith AB, Raynor M, Amling CL, et al. Multi-institutional analysis of robotic radical cystectomy for bladder cancer: perioperative outcomes and complications in 227 patients. J Laparoendosc Adv Surg Tech A. 2012;22(1):17–21.PubMedCrossRefGoogle Scholar
  9. 9.
    Ng CK, Kauffman EC, Lee MM, et al. A comparison of postoperative complications in open versus robotic cystectomy. Eur Urol. 2010;57(2):274–81.PubMedCrossRefGoogle Scholar
  10. 10.
    Nix J, Smith A, Kurpad R, Nielsen ME, Wallen EM, Pruthi RS. Prospective randomized controlled trial of robotic versus open radical cystectomy for bladder cancer: perioperative and pathologic results. Eur Urol. 2010;57(2):196–201.PubMedCrossRefGoogle Scholar
  11. 11.
    Butt ZM, Fazili A, Tan W, et al. Does the presence of significant risk factors affect perioperative outcomes after robot-assisted radical cystectomy? BJU Int. 2009;104(7):986–90.PubMedCrossRefGoogle Scholar
  12. 12.
    Butt ZM, Perlmutter AE, Piacente PM, et al. Impact of body mass index on robot-assisted radical cystectomy. JSLS. 2008;12(3):241–5.PubMedGoogle Scholar
  13. 13.
    Hayn MH, Hellenthal NJ, Seixas-Mikelus SA, et al. Is patient outcome compromised during the initial experience with robot-assisted radical cystectomy? Results of 164 consecutive cases. BJU Int. 2011;108:882–7.PubMedGoogle Scholar
  14. 14.
    Pruthi RS, Smith A, Wallen EM. Evaluating the learning curve for robot-assisted laparoscopic radical cystectomy. J Endourol. 2008;22(11):2469–74.PubMedCrossRefGoogle Scholar
  15. 15.
    Schumacher MC, Jonsson MN, Hosseini A, et al. Surgery-related complications of robot-assisted radical cystectomy with intracorporeal urinary diversion. Urology. 2011;77(4):871–6.PubMedCrossRefGoogle Scholar
  16. 16.
    Bucher P, Gervaz P, Soravia C, Mermillod B, Erne M, Morel P. Randomized clinical trial of mechanical bowel preparation versus no preparation before elective left-sided colorectal surgery. Br J Surg. 2005;92(4):409–14.PubMedCrossRefGoogle Scholar
  17. 17.
    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.PubMedCrossRefGoogle Scholar
  18. 18.
    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.PubMedCrossRefGoogle Scholar
  19. 19.
    Chang SS, Cookson MS, Baumgartner RG, Wells N, Smith Jr JA. Analysis of early complications after radical cystectomy: results of a collaborative care pathway. J Urol. 2002;167(5):2012–6.PubMedCrossRefGoogle Scholar
  20. 20.
    Poulsen AL, Horn T, Steven K. Radical cystectomy: extending the limits of pelvic lymph node dissection improves survival for patients with bladder cancer confined to the bladder wall. J Urol. 1998;160(6 Pt 1):2015–9. discussion 20.PubMedGoogle Scholar
  21. 21.
    Davis JW, Gaston K, Anderson R, et al. Robot assisted extended pelvic lymphadenectomy at radical cystectomy: lymph node yield compared with second look open dissection. J Urol. 2011;185(1):79–83.PubMedCrossRefGoogle Scholar
  22. 22.
    Lavery HJ, Martinez-Suarez HJ, Abaza R. Robotic extended pelvic lymphadenectomy for bladder cancer with increased nodal yield. BJU Int. 2011;107(11):1802–5.PubMedCrossRefGoogle Scholar
  23. 23.
    Yee DS, Ornstein DK. Repair of rectal injury during robotic-assisted laparoscopic prostatectomy. Urology. 2008;72(2):428–31.PubMedCrossRefGoogle Scholar
  24. 24.
    Kheterpal E, Bhandari A, Siddiqui S, Pokala N, Peabody J, Menon M. Management of rectal injury during robotic radical prostatectomy. Urology. 2011;77(4):976–9.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  1. 1.Department of UrologyThe University of North Carolina at Chapel HillChapel HillUSA

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