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Background: Complication reporting is highly variable and nonstandardized. Therefore, it is imperative to determine the surgical outcomes of major oncologic procedures., Objective: To describe the complications after robot-assisted radical cystectomy (RARC) using a standardized and validated reporting methodology., Design, Setting, and Participants: Using the International Robotic Cystectomy Consortium (IRCC) database, we identified 939 patients who underwent RARC, had available complication data, and had at least 90 d of follow-up., Outcome Measurements and Statistical Analysis: Complications were analyzed and graded according to the Memorial Sloan-Kettering Cancer Center (MSKCC) system and were defined and stratified by organ system. Secondary outcomes included identification of preoperative and intraoperative variables predicting complications. Logistic regression models were used to define predictors of complications and readmission., Results and Limitations: Forty-one percent (n=387) and 48% (n=448) of patients experienced a complication within 30 and 90 d of surgery, respectively. The highest grade of complication was grade 0 in 52%, grade 1-2 in 29%, and grade 3-5 in 19% patients. Gastrointestinal, infectious, and genitourinary complications were most common (27%, 23%, and 17%, respectively). On multivariable analysis, increasing age group, neoadjuvant chemotherapy, and receipt of blood transfusion were independent predictors of any and high-grade complications, respectively. Thirty and 90-d mortality was 1.3% and 4.2%, respectively. As a multi-institutional database, a disparity in patient selection, operating standards, postoperative management, and reporting of complications can be considered a major limitation of the study., Conclusions: Surgical morbidity after RARC is significant when reported using a standardized reporting methodology. The majority of complications are low grade. Strict reporting of complications is necessary to advocate for radical cystectomy (RC) and helps in patient counseling., (Copyright © 2013 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Our objective was to assess the accuracy of gravimetric estimation of intraoperative blood loss using the colorimetric method. Forty laparotomy sponges were selected randomly from general gynecology cases during a 2 month period. The blood contained on each sponge had been assessed by the OR staff by weighing the sponges. The hemoglobin contained in the sponges was then converted to alkali hematin and measured in a Beckman spectrophotometer at 465 nm. Using the patient's preoperative hemoglobin measurement, the amount of blood present in the sponges was determined. The gravimetric and colorimetric measurements were compared statistically. We found no statistically significant correlation between the amount of blood loss estimated by the gravimetric method and the actual blood loss as measured by the colorimetric method (P = 0.074). The gravimetric method of assessing intraoperative blood loss is neither precise nor accurate.