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Novel Antibiotic-Irrigating Wound Protector Reduces Infectious Complications in Robot-Assisted Radical Cystectomy with Extracorporeal Urinary Diversion.
Kim, Albert H; Ruel, Nora H; Yamzon, Jonathan; Zhumkhawala, Ali-Ashgar; Lau, Clayton S; Yuh, Bertram E; Chan, Kevin G.
Afiliación
  • Kim AH; City of Hope National Medical Center, Division of Urology and Urologic Oncology, Department of Surgery, Duarte, CA.
  • Ruel NH; City of Hope National Medical Center, Division of Biostatistics, Department of Computational and Biostatistics, Duarte, CA.
  • Yamzon J; City of Hope National Medical Center, Division of Urology and Urologic Oncology, Department of Surgery, Duarte, CA.
  • Zhumkhawala AA; City of Hope National Medical Center, Division of Urology and Urologic Oncology, Department of Surgery, Duarte, CA.
  • Lau CS; City of Hope National Medical Center, Division of Urology and Urologic Oncology, Department of Surgery, Duarte, CA.
  • Yuh BE; City of Hope National Medical Center, Division of Urology and Urologic Oncology, Department of Surgery, Duarte, CA.
  • Chan KG; City of Hope National Medical Center, Division of Urology and Urologic Oncology, Department of Surgery, Duarte, CA. Electronic address: kchan@coh.org.
Urology ; 159: 160-166, 2022 01.
Article en En | MEDLINE | ID: mdl-34678310
OBJECTIVE: To determine whether use of an antibiotic-irrigating wound protector (AWP) reduces infectious complications after robotic radical cystectomy with extracorporeal urinary diversion (RCUD). METHODS: A prospectively maintained bladder cancer database was queried for patients undergoing robotic RCUD at a tertiary referral center one year prior to implementing an AWP and one year after (2018-2020). All diversions were performed extra-corporally. 92 patients total. 46 consecutive patients using a traditional wound protector (TWP) and 46 consecutive with an AWP. Infections were classified as symptomatic urinary tract infection, blood stream infection, and surgical site infection. The incidence of infectious complications at 30- and 90-days were compared. RESULTS: Baseline patient characteristics between the 2 groups showed no statistically significant differences. The overall complication rate was 65.2% in the TWP group and 26.1% in the AWP group at 30-days, and 67.4% vs 30.4% at 90-days. Focusing on infections, the 30-day complication rate was 30.4% in the TWP group compared to 6.5% in the AWP group (P =.003). This pattern persisted at 90-days with 37.0% in the TWP group compared to 6.5% in the AWP group (P =.004). Most complications were symptomatic UTI and blood stream infections, 14/24 (58%), requiring parenteral antibiotic treatment. CONCLUSION: We provide preliminary data showing use of an AWP can reduce infectious complications after RCUD. While larger prospective studies are warranted, our findings are a significant step towards decreasing morbidity of an already highly morbid procedure.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Infección de la Herida Quirúrgica / Infecciones Urinarias / Neoplasias de la Vejiga Urinaria / Cistectomía / Bacteriemia / Irrigación Terapéutica / Antibacterianos Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Urology Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Complicaciones Posoperatorias / Infección de la Herida Quirúrgica / Infecciones Urinarias / Neoplasias de la Vejiga Urinaria / Cistectomía / Bacteriemia / Irrigación Terapéutica / Antibacterianos Tipo de estudio: Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Aged / Female / Humans / Male País/Región como asunto: America do norte Idioma: En Revista: Urology Año: 2022 Tipo del documento: Article Pais de publicación: Estados Unidos