NDLI: Short-term morbidity and mortality of Indiana pouch, ileal conduit, and neobladder urinary diversion following radical cystectomy.

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Short-term morbidity and mortality of Indiana pouch, ileal conduit, and neobladder urinary diversion following radical cystectomy.

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Short-term morbidity and mortality of Indiana pouch, ileal conduit, and neobladder urinary diversion following radical cystectomy.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Monn, M. Francesca Kaimakliotis, Hristos Z. Cary, K. Clint Pedrosa, Jose A. Flack, Chandra K. Koch, Michael O. Bihrle, Richard
Spatial Coverage	United States
Description	Author Affiliation: Monn MF ( Department of Urology, Indiana University School of Medicine, Indianapolis, IN. Electronic address: mmonn@iupui.edu.); Kaimakliotis HZ ( Department of Urology, Indiana University School of Medicine, Indianapolis, IN.); Cary KC ( Department of Urology, Indiana University School of Medicine, Indianapolis, IN.); Pedrosa JA ( Department of Urology, Indiana University School of Medicine, Indianapolis, IN.); Flack CK ( Department of Urology, Indiana University School of Medicine, Indianapolis, IN.); Koch MO ( Department of Urology, Indiana University School of Medicine, Indianapolis, IN.); Bihrle R ( Department of Urology, Indiana University School of Medicine, Indianapolis, IN.)
Abstract	PURPOSE: Literature surrounding Indiana pouch (IP) urinary diversion suggests a higher incidence of complications and longer operative time compared with ileal conduit (IC) and neobladder (NB). We sought to assess short-term complications of IP diversions compared with other diversions at our institution. MATERIALS AND METHODS: Using institutional National Surgical Quality Improvement Program data, we identified radical cystectomy cases performed for bladder cancer at Indiana University from January 2011 until June 2013. During this time period, the National Surgical Quality Improvement Program randomly evaluated approximately 70% of radical cystectomies performed for urothelial carcinoma at our institution. Multivariable logistic regression was performed to identify factors associated with Clavien grade III-V complications. RESULTS: A total of 233 cases were identified, 139 IC, 39 IP, and 55 NB. Mean (standard deviation) operative times for IC, IP, and NB were 257 (84), 383 (78), and 327 (88) minutes, respectively (P<0.001). Half of the patients required blood transfusion during the hospitalization. The overall rate of complications was significantly lower among NB (P = 0.009). Overall, 12% of patients developed a Clavien grade III-V complication, with no difference observed between groups (P = 0.884). After controlling for preoperative confounders, IP patients were not at increased odds of developing a Clavien III-V complication compared with IC (odds ratio = 1.38, P = 0.599). CONCLUSIONS: At a high-volume center, the incidence of serious complications was similar between diversion types. IP patients were more likely to experience minor complications. Patients should be counseled regarding rates of short-term complications and blood transfusion.
File Format	HTM / HTML
ISSN	10781439
Issue Number	8
Volume Number	32
e-ISSN	18732496
Journal	Urologic Oncology: Seminars and Original Investigations
Language	English
Publisher	Elsevier
Publisher Date	2014-11-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Urology Discipline Oncology Cystectomy Mortality Urinary Bladder Neoplasms Surgery Urinary Diversion Aged Female Humans Male Middle Aged Morbidity Neoplasm Grading Quality Of Life Treatment Outcome United States Epidemiology Pathology Journal Article
Content Type	Text
Resource Type	Article
Subject	Urology Oncology

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