Risk Factor Analysis Of Post-operative Complications In Radical Cystectomy

Objective: To investigate early-term complications(hospitalization and within 90 days)of radical cystectomy and its associated specific risk factors. Methods:The clinical data from 114 consecutive cases of radical cystectomy from January 2010 to December 2014 were collected and reviewed.All complications within 90 days and hospitalization of surgery were recorded and classified using a 5-grade modification of the Clavien system. And analysis the associated specific risk factors of early-term complications by using the single factor X2 test and the Logistics regression analysis. Results:Of the 114 subjects at least 1 postoperative complication developed in 66(57.9%).According to the modified Clavien system,2 patients(1.8%) had grade I,48 patients(42.1%) had grade II,9 patients(7.9%) had grade III,and 5 patients(4.4%) had grade IV, 2 patients(1.8%) had grade V complications. The most frequent complication was urinary system infection(28.9%), then the postoperative intestinal obstruction(17.9%),respiratory tract infection(12.3%), infection of incision( 10.5%) and anastomotic leakage(6.1%)。According to the X2 test, operation-bleeding(P=0.034), operation classified with open radical cystectomy and laparoscopic radical cystectomy(P=0.027) were associated with the development of complications.Pathological stage(P=0.049)and pre-operation hypoalbuminemia( P=0.031) were associated with the development of serious complications. Then analysis those risk factors in Logistics regression. About the risk factors associated with the development of complications, the probability of postoperative complications who`s operaion-bleeding more than 400 ml is 1.923 times higher than the less ones, the probability of LRC`s postoperative complications is 0.482 times of the ORC`s. About the risk factors were associated with the development of serious complications, the probability of postoperative complications who have normal albumin before operation is 0.462 times of the lower ones, the patients whose pathologica stage were p T3~p T4 is 3.111 times higher than the others about the probability of postoperative complications. Conclusions: The Clavien system was available for researching the early-term complications of radical cystectomy. The operation-bleeding, operation classified with open radical cystectomy and laparoscopic radical cystectomy were associated with the development of complications.The pathological stage and pre-operation hypoalbuminemia were associated with the development of serious complications. Acknowledgment of the patients’ specific risk factors and monitoring perioperative processes may effectibely reduce risks and improve outcomes of the patients.