[Complications after radical cystectomy in patients with bladder carcinoma].

Abstract

To describe the frequency and type of complications after radical cystectomy for cancer of the urinary bladder and their relationship with the different types of urinary diversion techniques utilized.
We conducted a retrospective study of 166 patients who underwent radical cystectomy in the same department of urology over a period of 12 years. The intraoperative, early, late complications and the need for postoperative treatments are analyzed according to percentages, main trends, scatter and confidence interval.
87.3% of the patients were male. The most common tumor stage was pT3 (37.9%). Transintestinal urinary diversion was performed in 81.1%; the most common being cutaneous ureteroileostomy (44%) and external diversion (64.1%). 16.7% presented hyperchloremic metabolic acidosis. Intraoperative, early and late complications were observed in 53.6%, 47.5% and 71.1% of the survivors for each time period, respectively. 28.3% of the patients required some type of medical treatment in the course of their disease and 30.7% required some type of surgical or percutaneous procedure. The most frequent complications were intraoperative bleeding (50%), respiratory complications early postoperatively (12.6%) and chronic urinary infection as late complication (30.7%).
The high percentage of complications in our series is basically due to the fact that all types of complications, whether directly related or not to the disease and surgical procedure, were included. There was a higher incidence of late complications, the survival time being an important factor that influences the presentation of these complications. Complications are directly related to the type of urinary diversion performed, patient age, tumor stage and previous morbidity. The appearance of complications carries a high percentage of long-term complementary medical treatments or surgical and percutaneous procedures.