1133 Radical Cystectomies: What Came First, the CRP or the Complication?
A Yousaf, D Whiting, S Janardanan, M Perry- Surgery
Abstract
Introduction
Despite being gold standard treatment for some bladder cancers, radical cystectomy is a procedure with high rates of morbidity and mortality often due to development of post-operative complications. Here we present the rates of complications for patients undergoing robotic-assisted radical cystectomies (RARC) in a single, high-volume centre and their association with early postoperative CRP values.
Method
This retrospective study looked at data from 500 patients who underwent RARC at one hospital from April 2013 to April 2021. Postoperative complications were analysed to assess the value of using early post-operative CRP as a predictor for development of those complications.
Results
499 patients were included in the study of which there were 369 men (74%) and 130 women (26%) with a mean age of 69.4 years. The majority of patients had a RARC with formation of ileal conduit (84.6%), or RARC with formation of a neobladder (4.6%). 154 patients experienced a complication fitting into Clavien-Dindo Class I or above. 92 patients experienced ileus (60%) followed by infection (20.1%). On multivariant analysis, we have identified a statistically significant association with early post-operative CRP values at days 1-3, peaking at day 3, and the development of post-operative complications.
Conclusions
We have shown that analysis of early postoperative CRP values may be beneficial for patients undergoing urological procedures. Earlier identification of patients whose investigations suggest they are likely to develop post-operative complications will allow clinicians to take action earlier on during their admission in an attempt to reduce morbidity for patients.