Cystectomy for benign disease: Readmission, morbidity, and complications

Scott G. Erpelding, Adam Dugan, Sudhir Isharwal, Stephen Strup, Andrew James, Shubham Gupta

Research output: Contribution to journalArticle

Abstract

Introduction: We sought to elucidate outcomes and risks associated with cystectomy and urinary diversion for benign urological conditions compared to malignant conditions. Materials and methods: We identified patients who underwent cystectomy and urinary diversion for benign and malignant diseases through the American College of Surgeons National Surgery Quality Improvement Program database for the period 2007-2015. Patients were selected for inclusion based upon their current procedure terminology and International Classification of Disease, Ninth revision codes. Primary outcome was 30 day morbidity including return to the operating room (OR); infectious, respiratory, and/or cardiovascular complications; readmission to the hospital; and mortality. Multivariable regression analyses were performed to identify associated factors. Results: A total of 317 patients underwent cystectomy and urinary diversion for benign disease, and 5510 patients underwent radical cystectomy with urinary diversion for cancer. Rates of major morbidity (43.2% versus 38.6%), mortality (0.9% versus 1.9%), return to OR (5% versus 5.8%), readmission (19.7% versus 21.4%), postoperative sepsis (14.5% versus 12%), and wound complications (16.1% versus 14.2%) were similar among patients undergoing cystectomy for benign and malignant conditions. In the group with cystectomy for benign conditions, smoking (OR: 3.11) and longer operative duration (OR: 1.06) were significantly associated with increased overall morbidity. Wound complications were significantly higher in smokers (OR: 3.09) and with an ASA = III (OR: 5.71) Conclusions: Patients undergoing cystectomy and urinary diversion for benign disease are at similar risk for 30 day morbidity and mortality as patients undergoing surgery for malignant conditions. Risk factors are identified that can potentially be targeted for morbidity reduction.

Original languageEnglish (US)
Pages (from-to)9473-9479
Number of pages7
JournalCanadian Journal of Urology
Volume25
Issue number5
StatePublished - Oct 1 2018
Externally publishedYes

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Cystectomy
Operating Rooms
Urinary Diversion
Morbidity
Mortality
Patient Readmission
Wounds and Injuries
International Classification of Diseases
Quality Improvement
Terminology
Sepsis
Smoking
Regression Analysis
Databases
Neoplasms

Keywords

  • Cystectomy
  • Morbidity
  • Readmission

ASJC Scopus subject areas

  • Urology

Cite this

Erpelding, S. G., Dugan, A., Isharwal, S., Strup, S., James, A., & Gupta, S. (2018). Cystectomy for benign disease: Readmission, morbidity, and complications. Canadian Journal of Urology, 25(5), 9473-9479.

Cystectomy for benign disease : Readmission, morbidity, and complications. / Erpelding, Scott G.; Dugan, Adam; Isharwal, Sudhir; Strup, Stephen; James, Andrew; Gupta, Shubham.

In: Canadian Journal of Urology, Vol. 25, No. 5, 01.10.2018, p. 9473-9479.

Research output: Contribution to journalArticle

Erpelding, SG, Dugan, A, Isharwal, S, Strup, S, James, A & Gupta, S 2018, 'Cystectomy for benign disease: Readmission, morbidity, and complications', Canadian Journal of Urology, vol. 25, no. 5, pp. 9473-9479.
Erpelding SG, Dugan A, Isharwal S, Strup S, James A, Gupta S. Cystectomy for benign disease: Readmission, morbidity, and complications. Canadian Journal of Urology. 2018 Oct 1;25(5):9473-9479.
Erpelding, Scott G. ; Dugan, Adam ; Isharwal, Sudhir ; Strup, Stephen ; James, Andrew ; Gupta, Shubham. / Cystectomy for benign disease : Readmission, morbidity, and complications. In: Canadian Journal of Urology. 2018 ; Vol. 25, No. 5. pp. 9473-9479.
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