Surgical complications of radical cystectomy in a teaching hospital

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dc.contributor.authorAucamp J.W.
dc.contributor.authorHeyns C.F.
dc.date.accessioned2011-05-15T16:18:07Z
dc.date.available2011-05-15T16:18:07Z
dc.date.issued1995
dc.description.abstractWe reviewed the surgical complications in 112 consecutive patients who had undergone radical cystectomy for bladder cancer at Tygerberg Hospital between 1978 and 1989. The cystectomies were performed by a total of 16 surgeons, of whom 1 (A) performed 30 and assisted at 2, 1 (B) performed 26 and assisted at 4, 2 (C+D) performed 27 and assisted at 16, and 12 (E-P) performed 29 and assisted at 46. Pre-operative radiotherapy was given in 37% of cases and intravesical chemotherapy in 25%. Major coexisting medical problems were present in 60%. The overall peri-operative mortality rate was 11%, but the rate was significantly lower (3%) in the group of patients operated on by surgeon A than in those operated on by surgeons E-P (21%). Major early postoperative complications occurred in 17% of the patients and major late complications in 25%. There were no significant differences between the different surgical groups in early and late complication rates. Peri-operative mortality and major early complications were significantly increased in patients aged over 71 years compared with those aged under 60 years. Peri-operative mortality was significantly increased in patients who had not received pre-operative radiotherapy compared with those who had done so. The presence of major coexistent medical problems did not significantly affect the rates of peri-operative mortality or major early or late surgical complications. Peri-operative mortality was lower in patients with T0-1 tumours than in those with T2-4 tumours, but the stage did not affect the incidence of major early or late surgical complications. Mortality and morbidity were not increased in patients who had undergone pelvic lymphadenectomy. Our study indicates that peri-operative mortality after radical cystectomy is significantly increased in cases of surgeons with limited experience performing the operation, in patients over 71 years old, in those who have not received preoperative radiotherapy, and in those with locally advanced tumours.
dc.description.versionArticle
dc.identifier.citationSouth African Journal of Surgery
dc.identifier.citation33
dc.identifier.citation1
dc.identifier.issn00382361
dc.identifier.urihttp://hdl.handle.net/10019.1/14521
dc.subjectadolescent
dc.subjectadult
dc.subjectage
dc.subjectaged
dc.subjectarticle
dc.subjectbladder cancer
dc.subjectcancer staging
dc.subjectchemotherapy
dc.subjectcystectomy
dc.subjectfemale
dc.subjecthuman
dc.subjectincidence
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectmorbidity
dc.subjectmortality
dc.subjectpelvis lymphadenectomy
dc.subjectpostoperative complication
dc.subjectpreoperative radiotherapy
dc.subjectschool child
dc.subjectsouth africa
dc.subjectsurgical mortality
dc.subjectsurgical risk
dc.subjectsurgical training
dc.subjectteaching hospital
dc.subjectAdolescent
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subjectBladder
dc.subjectBladder Neoplasms
dc.subjectChild
dc.subjectClinical Competence
dc.subjectConfounding Factors (Epidemiology)
dc.subjectCystectomy
dc.subjectFemale
dc.subjectHospitals, Teaching
dc.subjectHuman
dc.subjectMale
dc.subjectMiddle Age
dc.subjectPostoperative Complications
dc.subjectRetrospective Studies
dc.subjectSouth Africa
dc.titleSurgical complications of radical cystectomy in a teaching hospital
dc.typeArticle
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