eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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4/2020
vol. 16
 
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Urology
abstract:
Clinical research

Prediction of the risk of surgical complications in patients undergoing monopolar transurethral resection of bladder tumour – a prospective multicentre observational study

Sławomir Poletajew
1
,
Wojciech Krajewski
2
,
Dominika Gajewska
3
,
Joanna Sondka-Migdalska
4
,
Michał Borowik
5
,
Paweł Buraczyński
6
,
Mateusz Dzięgała
2
,
Marcin Łykowski
1
,
Maciej Przudzik
5
,
Andrzej Tukiendorf
7
,
Rafał Woźniak
8
,
Krzysztof Bar
6
,
Zbigniew Jabłonowski
4
,
Marek Roslan
5
,
Marcin Słojewski
3
,
Romuald Zdrojowy
2
,
Piotr Radziszewski
1
,
Konrad Dziobek
9

1.
Department of General, Oncological, and Functional Urology, Medical University of Warsaw, Warsaw, Poland
2.
Department of Urology and Oncological Urology, Wrocław Medical University, Wrocław, Poland
3.
Department of Urology and Urological Oncology, Pomeranian Medical University, Szczecin, Poland
4.
1st Department of Urology, Medical University in Łódź, Łódź, Poland
5.
Department of Urology, University of Warmia and Mazury, Olsztyn, Poland
6.
Department of Urology and Urologic Oncology, Medical University of Lublin, Lublin, Poland
7.
Social Medicine Department, Wrocław Medical University, Wrocław, Poland
8.
Chair of Statistics and Econometrics, Faculty of Economic Sciences, University of Warsaw, Warsaw, Poland
9.
Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Krakow Branch, Krakow
Arch Med Sci 2020; 16 (4): 863–870
Online publish date: 2019/10/07
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Introduction
The aim of the study was to identify predictors of surgical complications of transurethral resection of bladder tumour (TURBT).

Material and methods
We prospectively recruited 983 consecutive patients undergoing TURBT within 7 months in six academic institutions. All patients were followed up from the surgery up to 30 days postoperatively with at least one telephone contact at the end of the observation. The primary study endpoint was any intra- or postoperative surgical complication. For the identification of predictors of complications, univariate and multivariate logistic regression models were used. Trial registration: ClinicalTrials.gov (NCT03029663). Registered 24 January 2017.

Results
Surgical complications were noticed in 228 (23.2%) patients, including 83 (8.4%) patients with more than one complication and 33 cases of Clavien-Dindo grade 3 complications (3.3%). The most common in-hospital complications were bleeding (n = 139, 14.1%) and bladder perforation (n = 46, 4.7%). In a multivariate analysis, nicotine use, high ASA score, and the presence of high-grade tumour were the most significant predictors of high-grade complications. The stage of the disease was the strongest predictor of bleeding, while the presence of muscle in the specimen and resident surgeon were the strongest predictors for bladder perforation.

Conclusions
TURBT poses a significant risk of surgical complications, the majority of which are of low grade.

keywords:

bladder cancer, transurethral resection of bladder tumour, postoperative complications, intraoperative complications, residency

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