| Background and purposeTo retrospectively review the30-day postoperative morbidities of the patient following radical cystectomy (RC). Try to find some predictors of postoperative morbidity. In the reports of2002, bladder cancer age-standardized incidence rate of men is3.8/10,000and women is1.4/10,000; male bladder cancer incidence rate is eighth among the systemic tumor, women came in the twelfth. In recent years, some Chinese cities in tumor incidence report shows that bladder cancer incidence rates tend to increase. Bladder cancer occurs in the elderly, and its incidence increase with age. Radical cystectomy is the standard treatment of myometrial invasion of bladder cancer; to be elected one of the treatment is high-grade non-muscle invasive bladder cancer which is an effective way to improve the target survival rate of patients, to avoid local recurrence and distant metastasis.The surgical of RC is complexity, with large trauma, long operative time, and the surgical patients with older age, which may bring a series of early and long-term complications. Despite the improved surgical techniques, strengthening the preoperative preparation and perioperative care, postoperative complications are still very significant. Meanwhile the perioperative mortality of RC controlled within an acceptable range of patients and physicians, but still occur.The incidence of "early complications," defined as occurring either during the hospitalization or within30d of surgery, has been reported in the range of20%to60.4%, meanwhile the severity of complications was quite different. Domestic in this regard is still lack of a large sample, statistical analysis of data. This study attempts to combination of Postoperative Complication Grading System (2009) and using the complication classification methods to analyze the early postoperative complications of urinary diversion in the hospital over the past10years. in order to provide a reference for counseling patients, combined modality treatment planning, clinical trial design, and assessment of surgical success.MethodBetween January2000and October2010,313consecutive RCs were entered into a complication database from the Department of Urology of Southwest Hospital, Third Military Medical University and retrospectively reviewed for accuracy. Univariate regression models were used to define predictors of complications.Result1,Of313patients118(37.7%) experienced at least1complication within30days of surgery.2,Of the patients77.1%had minor and22.9%had major complications. The30-day mortality rate was1.3%.3,Incomplete ileus were most common (17.0%)followed by Posterior Urethral Stricture (14.5%) and Urinary leak (12.6%). When complications were defined and stratified into8specific categories, genitourinary complications were most common (37.1%), followed by gastrointestinal complications (20.8%) and wound-related complications (18.2%).4,On univariate analysis the incidence and severity of the30-day complications rate correlate highly significantly with age(P=0.014), postoperative length of stay (P<0.0005), American Society of Anesthesiologists score (P=0.019) and volume of blood transfusion.Conclusion1,Surgical morbidity following RC is significant even in the most experienced hands. But the rate of severe and lethal complications is acceptably low.2,Accurate reporting of postoperative complications after RC is essential for clinical trial design, combined modality treatment planning, and counseling patients around the operation...
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