Lower bleeding volume contributes to decreasing surgical site infection in radical cystectomy : A propensity score-matched comparison of open versus robot-assisted radical cystectomy
© 2024 The Authors. International Journal of Urology published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Urological Association..
OBJECTIVES: To compare the incidence of surgical site infections (SSI) between robot-assisted and open radical cystectomies and investigate the risk factors for SSI after radical cystectomies.
METHODS: Consecutive patients who underwent radical cystectomy between July 2008 and December 2022 were retrospectively reviewed. The prevalence and characteristics of SSI after open and robot-assisted radical cystectomies were compared, and the risk factors for SSI were investigated using propensity score matching.
RESULTS: This study enrolled 231 patients (open: 145, robot-assisted: 86). In the robot-assisted group, urinary diversion was performed using an intracorporeal approach. SSI occurred in 34 (open: 28, robot-assisted: 6) patients, and the incidence was significantly lower in the robot-assisted group (19.3% vs. 7.0%, p = 0.007). After propensity score matching cohort (open: 34, robot-assisted: 34), increased bleeding volume, blood transfusion, and delayed postoperative oral feeding were significantly associated with SSI. Only increased bleeding volume remained a significant risk factor in the multivariate regression analysis (odds ratio, 1.13 [per 100 mL increase]; 95% confidence interval: 1.02-1.25; p = 0.001). The cutoff bleeding volume for predicting SSI was 1630 mL with an area under the receiver operating characteristic curve, sensitivity, and specificity of 0.773, 0.73, and 0.75, respectively.
CONCLUSIONS: The incidence of SSI after robot-assisted radical cystectomy was significantly lower than that after the open procedure. However, decreased bleeding volume, which was significantly associated with robot-assisted procedures, was an independent and more significant factor for reducing SSI after radical cystectomy than the differences of the surgical procedure even after propensity score matching.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:31 |
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| Enthalten in: |
International journal of urology : official journal of the Japanese Urological Association - 31(2024), 4 vom: 12. Apr., Seite 430-437 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Kamei, Jun [VerfasserIn] |
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| Links: |
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| Themen: |
Bladder cancer |
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| Anmerkungen: |
Date Completed 17.04.2024 Date Revised 17.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1111/iju.15382 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM36663903X |
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| 100 | 1 | |a Kamei, Jun |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Lower bleeding volume contributes to decreasing surgical site infection in radical cystectomy |b A propensity score-matched comparison of open versus robot-assisted radical cystectomy |
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| 500 | |a Date Revised 17.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2024 The Authors. International Journal of Urology published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Urological Association. | ||
| 520 | |a OBJECTIVES: To compare the incidence of surgical site infections (SSI) between robot-assisted and open radical cystectomies and investigate the risk factors for SSI after radical cystectomies | ||
| 520 | |a METHODS: Consecutive patients who underwent radical cystectomy between July 2008 and December 2022 were retrospectively reviewed. The prevalence and characteristics of SSI after open and robot-assisted radical cystectomies were compared, and the risk factors for SSI were investigated using propensity score matching | ||
| 520 | |a RESULTS: This study enrolled 231 patients (open: 145, robot-assisted: 86). In the robot-assisted group, urinary diversion was performed using an intracorporeal approach. SSI occurred in 34 (open: 28, robot-assisted: 6) patients, and the incidence was significantly lower in the robot-assisted group (19.3% vs. 7.0%, p = 0.007). After propensity score matching cohort (open: 34, robot-assisted: 34), increased bleeding volume, blood transfusion, and delayed postoperative oral feeding were significantly associated with SSI. Only increased bleeding volume remained a significant risk factor in the multivariate regression analysis (odds ratio, 1.13 [per 100 mL increase]; 95% confidence interval: 1.02-1.25; p = 0.001). The cutoff bleeding volume for predicting SSI was 1630 mL with an area under the receiver operating characteristic curve, sensitivity, and specificity of 0.773, 0.73, and 0.75, respectively | ||
| 520 | |a CONCLUSIONS: The incidence of SSI after robot-assisted radical cystectomy was significantly lower than that after the open procedure. However, decreased bleeding volume, which was significantly associated with robot-assisted procedures, was an independent and more significant factor for reducing SSI after radical cystectomy than the differences of the surgical procedure even after propensity score matching | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a bladder cancer | |
| 650 | 4 | |a complications | |
| 650 | 4 | |a radical cystectomy | |
| 650 | 4 | |a robotic surgery | |
| 650 | 4 | |a surgical site infection | |
| 700 | 1 | |a Endo, Kaori |e verfasserin |4 aut | |
| 700 | 1 | |a Yamazaki, Masahiro |e verfasserin |4 aut | |
| 700 | 1 | |a Sugihara, Toru |e verfasserin |4 aut | |
| 700 | 1 | |a Takaoka, Ei-Ichiro |e verfasserin |4 aut | |
| 700 | 1 | |a Ando, Satoshi |e verfasserin |4 aut | |
| 700 | 1 | |a Kume, Haruki |e verfasserin |4 aut | |
| 700 | 1 | |a Fujimura, Tetsuya |e verfasserin |4 aut | |
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