Immediate Radical Cystectomy for Massive Bleeding of Bladder Cancer

Objective. To investigate feasibility and safety of our surgical strategy and clinical and oncological efficacy. Materials and Methods. In a high volume tertiary institution 225 radical cystectomies were performed from January 2012 to December 2014. We prospectively collected data of a cohort of 12...

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Main Authors:	Cochetti, Giovanni, Barillaro, Francesco, Boni, Andrea, Mearini, Ettore
Format:	Online
Language:	English
Published:	Hindawi Publishing Corporation 2015
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706858/

id	pubmed-4706858
recordtype	oai_dc
spelling	pubmed-47068582016-01-27 Immediate Radical Cystectomy for Massive Bleeding of Bladder Cancer Cochetti, Giovanni Barillaro, Francesco Boni, Andrea Mearini, Ettore Research Article Objective. To investigate feasibility and safety of our surgical strategy and clinical and oncological efficacy. Materials and Methods. In a high volume tertiary institution 225 radical cystectomies were performed from January 2012 to December 2014. We prospectively collected data of a cohort of 12 patients who underwent immediate open radical cystectomy for bladder cancer causing massive haematuria, acute anemia, and impossibility of postponing surgery. A retrospective study was carried out to evaluate operative data, intra- and postoperative complications, and oncologic outcomes. The Clavien-Dindo Classification was used to grade complications. The oncologic outcome was evaluated in terms of positive overall and soft tissue surgical margins and cancer specific survival at a median follow-up of 26 months. Results. Mean preoperative haemoglobin was 6.8 mg/dL. Mean operative time was 278 minutes. Mean blood loss was 633 mL. The overall transfusion rate was 100% with a mean of 3.6 blood units per patient before surgery and 1.8 units postoperatively. No intraoperative complications occurred. Major complications (defined as grades III, IV, and V according to Clavien-Dindo Classification) were 18,5%. In fact grade III complications were 14.8% and grade IV complications were 3.7%. Grade V did not occur. The positive surgical margin rate was 33.3% and cancer specific survival was 58,3% at median follow-up of 26 months. Conclusions. Immediate surgical management seems feasible, safe, and efficacious. Hindawi Publishing Corporation 2015 2015-12-24 /pmc/articles/PMC4706858/ /pubmed/26819948 http://dx.doi.org/10.1155/2015/154392 Text en Copyright © 2015 Giovanni Cochetti et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Cochetti, Giovanni Barillaro, Francesco Boni, Andrea Mearini, Ettore
spellingShingle	Cochetti, Giovanni Barillaro, Francesco Boni, Andrea Mearini, Ettore Immediate Radical Cystectomy for Massive Bleeding of Bladder Cancer
author_facet	Cochetti, Giovanni Barillaro, Francesco Boni, Andrea Mearini, Ettore
author_sort	Cochetti, Giovanni
title	Immediate Radical Cystectomy for Massive Bleeding of Bladder Cancer
title_short	Immediate Radical Cystectomy for Massive Bleeding of Bladder Cancer
title_full	Immediate Radical Cystectomy for Massive Bleeding of Bladder Cancer
title_fullStr	Immediate Radical Cystectomy for Massive Bleeding of Bladder Cancer
title_full_unstemmed	Immediate Radical Cystectomy for Massive Bleeding of Bladder Cancer
title_sort	immediate radical cystectomy for massive bleeding of bladder cancer
description	Objective. To investigate feasibility and safety of our surgical strategy and clinical and oncological efficacy. Materials and Methods. In a high volume tertiary institution 225 radical cystectomies were performed from January 2012 to December 2014. We prospectively collected data of a cohort of 12 patients who underwent immediate open radical cystectomy for bladder cancer causing massive haematuria, acute anemia, and impossibility of postponing surgery. A retrospective study was carried out to evaluate operative data, intra- and postoperative complications, and oncologic outcomes. The Clavien-Dindo Classification was used to grade complications. The oncologic outcome was evaluated in terms of positive overall and soft tissue surgical margins and cancer specific survival at a median follow-up of 26 months. Results. Mean preoperative haemoglobin was 6.8 mg/dL. Mean operative time was 278 minutes. Mean blood loss was 633 mL. The overall transfusion rate was 100% with a mean of 3.6 blood units per patient before surgery and 1.8 units postoperatively. No intraoperative complications occurred. Major complications (defined as grades III, IV, and V according to Clavien-Dindo Classification) were 18,5%. In fact grade III complications were 14.8% and grade IV complications were 3.7%. Grade V did not occur. The positive surgical margin rate was 33.3% and cancer specific survival was 58,3% at median follow-up of 26 months. Conclusions. Immediate surgical management seems feasible, safe, and efficacious.
publisher	Hindawi Publishing Corporation
publishDate	2015
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4706858/
_version_	1613521816145362944

Immediate Radical Cystectomy for Massive Bleeding of Bladder Cancer

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