Cystectomy: Difference between revisions
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== Adverse Events == | == Adverse Events == | ||
=== <span style="color:#ff0000"> | === Intra-operative === | ||
# '''<span style="color:#ff0000">Risks of general anesthesia (stroke, myocardial infraction, thrombosis)''' | |||
# '''Injury to adjacent organ (nerves, bowel, rectum)''' | # '''<span style="color:#ff0000">Injury to adjacent organ (nerves, bowel, rectum)''' | ||
# '''Bleeding +/- transfusion''' | # '''<span style="color:#ff0000">Bleeding +/- transfusion''' | ||
=== | === Early post-operative === | ||
# '''Gastrointestinal (29%)[https://pubmed.ncbi.nlm.nih.gov/33853799/]''' | # '''<span style="color:#ff0000">Gastrointestinal (29%)[https://pubmed.ncbi.nlm.nih.gov/33853799/]''' | ||
## '''Ileus (16%)''' | ## '''<span style="color:#ff0000">Ileus (16%)''' | ||
## '''Small bowel obstruction (5%)''' | ## '''<span style="color:#ff0000">Small bowel obstruction (5%)''' | ||
## '''Constipation (3%)''' | ## '''<span style="color:#ff0000">Constipation (3%)''' | ||
## '''Clostridium difficile colitis (2%)''' | ## '''<span style="color:#ff0000">Clostridium difficile colitis (2%)''' | ||
## ''' | ## '''<span style="color:#ff0000">Anastomotic bowel leak (1%)''' | ||
# '''Infection (26%)[https://pubmed.ncbi.nlm.nih.gov/33853799/]''' | # '''<span style="color:#ff0000">Infection (26%)[https://pubmed.ncbi.nlm.nih.gov/33853799/]''' | ||
## '''UTI/pyelonephritis (14%)''' | ## '''<span style="color:#ff0000">UTI/pyelonephritis (14%)''' | ||
## '''Sepsis (4$)''' | ## '''<span style="color:#ff0000">Sepsis (4$)''' | ||
## '''Pelvic/intra-abdominal abscess (2.4%)''' | ## '''<span style="color:#ff0000">Pelvic/intra-abdominal abscess (2.4%)''' | ||
# '''Ureteric anastamotic leak (3%)[https://pubmed.ncbi.nlm.nih.gov/33853799/]''' | # '''<span style="color:#ff0000">Ureteric anastamotic leak (3%)[https://pubmed.ncbi.nlm.nih.gov/33853799/]''' | ||
# '''Wound (13%)[https://pubmed.ncbi.nlm.nih.gov/33853799/]''' | # '''<span style="color:#ff0000">Wound (13%)[https://pubmed.ncbi.nlm.nih.gov/33853799/]''' | ||
## '''Dehiscence (4%)''' | ## '''<span style="color:#ff0000">Dehiscence (4%)''' | ||
## '''Fascial dehiscence (1.6%)''' | ## '''<span style="color:#ff0000">Fascial dehiscence (1.6%)''' | ||
## '''Infection (10%)''' | ## '''<span style="color:#ff0000">Infection (10%)''' | ||
# '''Need for secondary procedure''' | # '''<span style="color:#ff0000">Need for secondary procedure''' | ||
#'''Mortality''' | #'''<span style="color:#ff0000">Mortality''' | ||
#*'''2.4% (range 0.9–4.7) inpatient mortality rate and a 4.7% (range 0.0–7.0) 90-day mortality rate following radical cystectomy[https://pubmed.ncbi.nlm.nih.gov/33853799/]''' | #*'''2.4% (range 0.9–4.7) inpatient mortality rate and a 4.7% (range 0.0–7.0) 90-day mortality rate following radical cystectomy[https://pubmed.ncbi.nlm.nih.gov/33853799/]''' | ||
#** Mortality after radical cystectomy is typically < 5%, but may increase substantially in the elderly with 90-day mortality rates over 10% in patients > 75 years of age and almost 20% in octagenarians. | #** Mortality after radical cystectomy is typically < 5%, but may increase substantially in the elderly with 90-day mortality rates over 10% in patients > 75 years of age and almost 20% in octagenarians. | ||
=== | === Late post-operative === | ||
# '''Failure to cure''' | # '''<span style="color:#ff0000">Failure to cure''' | ||
# '''Metabolic consequences of diversion''' | # '''<span style="color:#ff0000">Metabolic consequences of diversion''' | ||
# '''Ureteral stricture''' | # '''<span style="color:#ff0000">Ureteral stricture''' | ||
# '''Hernia''' | # '''<span style="color:#ff0000">Hernia''' | ||
# '''Erectile dysfunction''' | # '''<span style="color:#ff0000">Erectile dysfunction''' | ||
# '''Infection''' | # '''<span style="color:#ff0000">Infection''' | ||
== Post-operative care == | == Post-operative care == | ||