How to lower postoperative complications after radical cystectomy – a review

W. Krajewski, R. Zdrojowy, K. Tupikowski, B. Małkiewicz, A. Kołodziej
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引用次数: 14

Abstract

Introduction Lowering morbidity and mortality after RC is subject of considerable interest. Lately, many evidence-based data on improvements in operative technique, anesthetic management, and patient care have been published. In this article, we present a review of literature on how to lower postoperative complications after RC. Material and methods The Medline, and Web of Science databases were searched without a time limit on February 2016 using the terms ‘cystectomy’ in conjunction with ‘radical’, ‘bladder cancer’, ‘complications’ or ‘management’. Boolean operators (NOT, AND, OR) were also used in succession to narrow and broaden the search. The search was limited to the English, Polish and Spanish literature. Results Many complications may be avoided by appropriate patient selection and meticulous introduction of care protocols. Conclusions RC as treatment free of complications, even in the hands of an experienced urologist, does not exist. A large number of complications are acceptable in the name of good long-term results. Optimum results are possible with proper surgical technique, good patients and urinary diversion selection and proper patient management in the pre-, peri, and postoperative period.
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如何降低根治性膀胱切除术后的并发症——综述
降低术后的发病率和死亡率是一个非常重要的课题。最近,许多关于手术技术、麻醉管理和患者护理改进的循证数据已经发表。在这篇文章中,我们回顾了关于如何降低RC术后并发症的文献。2016年2月,我们在Medline和Web of Science数据库中搜索了“膀胱切除术”和“根治性”、“膀胱癌”、“并发症”或“管理”等术语,没有时间限制。布尔运算符(NOT、AND、OR)也相继用于缩小和扩大搜索范围。搜索仅限于英语、波兰语和西班牙语文学。结果适当的患者选择和细致的护理方案可以避免许多并发症。结论RC作为无并发症的治疗方法,即使在经验丰富的泌尿科医生手中,也不存在。为了获得良好的长期效果,大量的并发症是可以接受的。在术前、围手术期和术后,通过适当的手术技术、良好的患者和尿分流选择以及适当的患者管理,可以获得最佳结果。
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