Transuretral resection of the bladder (TURB): Analysis of complications using a modified Clavien system in an Italian real life cohort
Transuretral resection of the bladder (TURB): Analysis of complications using a modified Clavien system in an Italian real life cohort
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DOI：
10.1016/j.ejso.2013.11.003
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发表时间：
2014-01-01
期刊：
影响因子：
3.8
通讯作者：
Tubaro, A.
中科院分区：
文献类型：
--
作者：
De Nunzio, C.;Franco, G.;Tubaro, A.
简介：为了评估的适用性，改良的Clavien分类系统（CCS）在分级经尿道膀胱肿瘤切除术（TURB.Materials and Methods）术后并发症：一系列患者接受单极TURB从2011年4月至2012年3月在五个意大利中心参加。术后30天内发生的所有并发症进行了前瞻性记录，并根据CCS分级。中位年龄为71（63/78）岁;中位BMI为28（25.4/30.8）Kg/m2，中位肿瘤大小为2（1-3）cm;中位肿瘤病变数量为1（1-3）。中位手术时间为30（20/45）min。57例并发症。在43名患者中记录。总体术后发病率为16%。大多数并发症不严重，归类为Clavien I型（42例，74%）或II型（8例，14%）。较高级别的并发症很少：CCS IIIa为1例（2%），CCS IIIb为6例（10%）。未报告TURB相关死亡。6例患者在术后第2-7天因严重出血或血凝块潴留而再次手术。单因素（73.5 +/- 38 vs 36.7 +/- 21.6 min）和多变量分析，手术时间较长是并发症的独立预测因素（OR：1.06/mm，95%CI 1.04-1.08，p = 0.001）。改良CCS可作为标准化工具，客观定义TURB并发症，证实TURB是一种安全的手术，手术发病率低。该工具可用于帮助患者咨询并促进科学评估。(C)2013爱思唯尔有限公司保留所有权利。
Introduction: To evaluate the applicability of a modified Clavien classification system (CCS) in grading postoperative complications of transurethral resection of bladder tumours (TURB).Materials and methods: A series of patients undergoing monopolar TURB from April 2011 to March 2012 at five Italian centers were enrolled. All complications occurring within the first 30-day postoperative period were prospectively recorded and graded according to the CCS.Results: Overall, 275 patients were included. Median age was 71(63/78) years; median BMI was 28 (25.4/30.8) Kg/m(2), median tumour size was 2 (1-3) cm; median number of tumour lesions was 1 (1-3). Median operative time was 30 (20/45) min. Fifty-seven complications. were recorded in 43 patients. Overall postoperative morbidity rate was 16%. Most of the complications were not serious and classified as Clavien type I (42 cases; 74%) or II (8 cases, 14%). Higher grade complications were scarce: CCS IIIa in 1 case (2%) and CCS IIIb in six cases (10%). No TURB related death was reported. Six patients were re-operated due to significant bleeding or clot retention on postoperative days 2-7. On univariate (73.5 +/- 38 versus 36.7 +/- 21.6 min) and multivariate analysis longer operative time was an independent predictor of complications (OR: 1.06 per mm, 95%CI 1.04-1.08, p = 0.001).Conclusions: A modified CCS can be used as a standardized tool to objectively define the complications of TURB which confirms to be a safe procedure with a low surgical morbidity. This tool can be used to aid in patient counselling and to facilitate scientific assessment. (C) 2013 Elsevier Ltd. All rights reserved.