Preliminary Conclusion And Prevention Of Early Complications After Laparoscopic Radical Cystectomy And Orthotopic Urinary Diversion

Objective(s):Laparoscopic cystectomy and orthotopic urinary diversion is a multi-step and difficult operation which involves multiple organs and takes a long time.Besides,most patients undergoing this surgery are generally older.Therefore,the early postoperative complications are high considerably.This study aimed to investigate the early postoperative complications of laparoscopic cystectomy and orthotopic urinary diversion,then put up with some preventive measures to provide effective clinical guidance.Methods:We retrospectively analyzed 66 bladder cancer patients who were undergoing laparoscopic cystectomy and orthotopic urinary diversion between January 2016 and November 2017 in the Second Affiliated Hospital of Kunming Medical University.Early postoperative complications were classified according to the improved Clavien system.Results:Early postoperative complications developed in 41 of 66 cases(62.1%),two and more complications developed in 31 cases,the total complications are 88.According to the improved Clavien system,there are 45(51.1%)mild complications,34(38.6%)moderate complications and 9(10.2%)severe complications.Urogenital tract infections and gastrointestinal related complications had a higher incidence and other complications had a lower incidence.BMI,operative time,intraoperative blood loss and hospital stay may be associated with the complication incidence of laparoscopic cystectomy and orthotopic urinary diversion.Conclusion(s):1.Although the Laparoscopic cystectomy and orthotopic urinary diversion had a high incidence of mild and moderate complications,the incidence of severe incidence was still low.2.The highest incidence of early complications was followed by urogenital tract、infections and gastrointestinal related complications that was in agreement with other studies.3.BMI,operative time,intraoperative blood loss and hospital stay may be associated with the complication incidence of laparoscopic cystectomy and orthotopic urinary diversion,and the length of hospital stay may be a causal relationship with early complications.4.There are some preventive measures to reduce the incidence of complication as follows:Rational screening of surgical patients before surgery;Strengthening management of patients with higher BMI;Improving operative skills to reduce bleeding and operative time;Strengthening postoperative management and reducing hospital stay.