[Analysis of perioperative complications of laparoscopic radical cystectomy for bladder cancer]

To evaluate operation process and perioperative complications of patients who underwent laparoscopic radical cystectomy (LRC).

The clinical data of 49 cases of LRC from October 2004 to June 2010 were reviewed retrospectively. Perioperative complications and mortality were analyzed, and so were the operative time, blood loss and postoperative hospital stay. Perioperative complications were defined as any adverse event within 30 days of surgery. All complications were graded according to an established five-grade modification of the original Clavien system.

The mean operation time was 418 minutes, the mean blood loss was 514 mL, the transfusion rate was 36.7%, the mean transfusion volume was 578 mL, and the average postoperative hospital stay was 20 d. For urinary diversion, ileal conduits were constructed in 27 patients (55.1%), ileal neobladders in 16 patients (32.7%), and ureterocutaneostomies in 6 patients (12.2%). A total of 17 patients (34.7%) developed at least one perioperative complication. Complications of grades 1-2 occurred in 12 patients (24.5%), which included subileus, urinary tract infections, deep venous thrombosis of the lower limbs, pneumonia, etc. Complications of grades 3-5 occurred in 5 patients(10.2%), and one patient died of pulmonary embolism. Ileal neobladders and ileal conduits were similar at the operation time, blood loss, transfusion rates, postoperative hospital stay and morbidity of perioperative complications.

Morbidity of perioperative complications following LRC was still high. The most frequent complications were subileus and urinary tract infections. The surgery should be performed on selected patients, and measures need to be taken to prevent these complications. Compared with ileal conduits, ileal neobladders did not increase the operation time, blood loss and morbidity.