THE COMPLICATIONS OF RADICAL CYSTECTOMY WITH ORTHOTOPIC URINARY DIVERSION

Objective. Radical cystectomy is a “gold standard” of treatment of patients with muscle-invasive or high risk non-muscle-invasive bladder cancer and is associated with high quantity of postoperative complications. The aim of our study was to analyse the complications of radical cystectomy with orthotopic urinary diversion. Material and methods. Studer radical cystectomy was performed in the Department of Urology in 57 patients in the age of 38-93 years (median - 67). In this group 45 (78.9%) were male and 12 (21.1%) were female. Results. Twenty four complications occurred in 20 of 57 patients (42.1%). Two patients (3.5%) died in the postoperative period. Three of 24 complications were bladder related, while 21 were due to other reasons. We registered 15 (26.3%) grade 1-2 and 9 (15.7) grade 3-5 complications according to Clavien-Dindo classification. Re-operation was required in 5 cases. Indications for surgery were: incompetence of bowel anastomosis (3/5.2%), mechanical bowel obstruction (1/1.7%) and wound-related complications (1/1.7%) cases. Conclusion. Radical cystectomy is a large-scale and complicated reconstructive urologic surgery, which is associated with considerable amount of postoperative complications. Surgery technic mastering, meticulous patient selection and robotic-assisted laparoscopic methods forthcoming are the keys to minimize the quantity of complications and surgery-related mortality. Keywords: radical cystectomy; bladder cancer; orthotopic plastic; complications of Clavien-Dindo.

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