Respiratory Complications after Cystectomy with Urinary Diversion: Avoidable Complications or Ineluctable Destiny?

Martinez Carrique, Silvia; Crettenand, François; Stritt, Kevin; Bohner, Perrine; Grilo, Nuno; Rodrigues-Dias, Sonia; Roth, Beat; Lucca, Ilaria (2024). Respiratory Complications after Cystectomy with Urinary Diversion: Avoidable Complications or Ineluctable Destiny? Journal of clinical medicine, 13(6) MDPI 10.3390/jcm13061585

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Background: Cystectomy with urinary diversion (CUD) is a highly morbid surgery. Despite implementing an enhanced recovery after surgery (ERAS®) protocol, postoperative respiratory complications (PRC) within 30 days after surgery remain frequent. This study aims to identify patients at higher risk of developing PRC after CUD. Methods: We conducted a retrospective analysis of 242 patients who underwent CUD at Lausanne University Hospital from 2012 to 2022, adhering to ERAS® guidelines. Data on postoperative complications, including pneumonia, respiratory failure, pulmonary embolism, lobar atelectasis, and pleural effusion, were analyzed. Chi-square and Mann-Whitney U tests compared patients with and without PRC. A multivariable Cox model identified independent prognostic factors. Results: PRC occurred in 41 patients (17%). Those with PRC experienced longer hospital stays and higher 30-day mortality rates. Poor ERAS® compliance was a significant risk factor. Multivariable analysis showed pneumonia was associated with postoperative ileus, while pulmonary embolism correlated with infectious and cardiovascular complications. Conclusions: PRC result in extended hospitalization and decreased survival. Rigorous adherence to ERAS® protocols, including early mobilization, respiratory physiotherapy, and avoiding nasogastric tubes, is essential for preventing PRC.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Dermatology, Urology, Rheumatology, Nephrology, Osteoporosis (DURN) > Clinic of Urology

UniBE Contributor:

Roth, Beat

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2077-0383

Publisher:

MDPI

Language:

English

Submitter:

Pubmed Import

Date Deposited:

03 Apr 2024 09:51

Last Modified:

04 Apr 2024 15:44

Publisher DOI:

10.3390/jcm13061585

PubMed ID:

38541810

Uncontrolled Keywords:

ERAS® cystectomy respiratory complications

BORIS DOI:

10.48350/195098

URI:

https://boris.unibe.ch/id/eprint/195098

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