TY  - EJOU
AU  - Erpelding, Scott G. 
AU  - Dugan, Adam 
AU  - Isharwal, Sudhir 
AU  - Strup, Stephen 
AU  - James, Andrew 
AU  - Gupta, Shubham 

TI  - Cystectomy for benign disease: readmission, morbidity, and complications
T2  - Canadian Journal of Urology

PY  - 2018
VL  - 25
IS  - 5
SN  - 1488-5581

AB  - <b>Introduction:</b> We sought to elucidate outcomes and risks associated with cystectomy and urinary diversion for benign urological conditions compared to malignant conditions.<br/>
<b>Materials and methods:</b> We identified patients who underwent cystectomy and urinary diversion for benign and malignant diseases through the American College of Surgeons National Surgery Quality Improvement Program database for the period 2007-2015. Patients were selected for inclusion based upon their current procedure terminology and International Classification of Disease, Ninth Revision codes. Primary outcome was 30-day morbidity, including return to the operating room (OR); infectious, respiratory, and/or cardiovascular complications; readmission to the hospital; and mortality. Multivariable regression analyses were performed to identify associated factors.<br/>
<b>Results:</b> A total of 317 patients underwent cystectomy and urinary diversion for benign disease, and 5,510 patients underwent radical cystectomy with urinary diversion for cancer. Rates of major morbidity (43.2% versus 38.6%), mortality (0.9% versus 1.9%), return to OR (5% versus 5.8%), readmission (19.7% versus 21.4%), postoperative sepsis (14.5% versus 12%), and wound complications (16.1% versus 14.2%) were similar among patients undergoing cystectomy for benign and malignant conditions. In the group with cystectomy for benign conditions, smoking (OR: 3.11) and longer operative duration (OR: 1.06) were significantly associated with increased overall morbidity. Wound complications were significantly higher in smokers (OR: 3.09) and with an ASA ≥ III (OR: 5.71).<br/>
<b>Conclusions:</b> Patients undergoing cystectomy and urinary diversion for benign disease are at similar risk for 30-day morbidity and mortality as patients undergoing surgery for malignant conditions. Risk factors are identified that can potentially be targeted for morbidity reduction.
KW  - cystectomy
KW  -  readmission
KW  -  morbidity

DO  -