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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.
Afiliación
  • Martinez Carrique S; Department of Urology, University Hospital of Lausanne, University of Lausanne, 1011 Lausanne, Switzerland.
  • Crettenand F; Department of Urology, University Hospital of Lausanne, University of Lausanne, 1011 Lausanne, Switzerland.
  • Stritt K; Department of Urology, University Hospital of Lausanne, University of Lausanne, 1011 Lausanne, Switzerland.
  • Bohner P; Department of Urology, University Hospital of Lausanne, University of Lausanne, 1011 Lausanne, Switzerland.
  • Grilo N; Department of Urology, University Hospital of Lausanne, University of Lausanne, 1011 Lausanne, Switzerland.
  • Rodrigues-Dias S; Department of Urology, University Hospital of Lausanne, University of Lausanne, 1011 Lausanne, Switzerland.
  • Roth B; Department of Urology, University Hospital of Lausanne, University of Lausanne, 1011 Lausanne, Switzerland.
  • Lucca I; Department of Urology, University Hospital of Bern, University of Bern, 3010 Bern, Switzerland.
J Clin Med ; 13(6)2024 Mar 10.
Article en En | MEDLINE | ID: mdl-38541810
ABSTRACT

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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Suiza
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: J Clin Med Año: 2024 Tipo del documento: Article País de afiliación: Suiza Pais de publicación: Suiza