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Risk factors for postoperative ileus after robot-assisted radical cystectomy with intracorporeal urinary diversion.
- Source :
-
International journal of urology : official journal of the Japanese Urological Association [Int J Urol] 2022 Jun; Vol. 29 (6), pp. 553-558. Date of Electronic Publication: 2022 Mar 01. - Publication Year :
- 2022
-
Abstract
- Objectives: To evaluate the risk factors for postoperative ileus in patients who underwent robot-assisted radical cystectomy with intracorporeal urinary diversion.<br />Methods: We retrospectively analyzed 78 patients with bladder cancer who underwent robot-assisted radical cystectomy with intracorporeal urinary diversion at Fujita Health University between 2011 and 2021. Baseline characteristics and perioperative outcomes were compared between the cohorts with and without ileus. Logistic regression analysis was used to identify the risk factors for postoperative ileus.<br />Results: Out of the 78 patients included in this study, 20 (25.6%) developed postoperative ileus. The ileus cohort was associated with a significantly lower Geriatric-8 score (P = 0.003) and a higher rate of previous abdominal/pelvic surgery (P = 0.04) compared with those of the nonileus cohort. Significantly longer intestinal tract reconstruction time, hospital stay, time to mobilization, fluid intake, solid intake, flatus, and stool were observed in the ileus cohort. According to the results of the logistic regression analysis, the Geriatric-8 sum (P = 0.009), time to mobilization (P = 0.03), and time to fluid intake (P = 0.004) were independent predictors of postoperative ileus. In the model predicting postoperative ileus, the area under the receiver operating characteristic curve was 0.716, and the cutoff value of the Geriatric-8 sum was 13.<br />Conclusions: Early mobilization and fluid intake and low Geriatric-8 scores were significant risk factors for postoperative ileus. Preoperative Geriatric-8 evaluation is a useful tool for predicting postoperative ileus. Comprehensive enhanced recovery after surgery, including key components, may help bowel recovery and prevent subsequent ileus.<br /> (© 2022 The Japanese Urological Association.)
- Subjects :
- Aged
Cystectomy adverse effects
Cystectomy methods
Humans
Postoperative Complications epidemiology
Postoperative Complications etiology
Postoperative Complications surgery
Retrospective Studies
Risk Factors
Treatment Outcome
Ileus complications
Ileus etiology
Robotic Surgical Procedures adverse effects
Robotic Surgical Procedures methods
Robotics
Urinary Bladder Neoplasms complications
Urinary Diversion adverse effects
Urinary Diversion methods
Subjects
Details
- Language :
- English
- ISSN :
- 1442-2042
- Volume :
- 29
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- International journal of urology : official journal of the Japanese Urological Association
- Publication Type :
- Academic Journal
- Accession number :
- 35229914
- Full Text :
- https://doi.org/10.1111/iju.14839