Complications in radical cystectomy performed at a teaching hospital.

Objectives: Radical cystectomy with urinary diversion has been the standard treatment to infiltrative bladder neoplasms. We have analyzed a series of radical cystectomies performed by residents at a school hospital and compared the rates of complications in this series with those reported in literature.

Materials And Methods: During the period of December 1996 to December 2000, 59 surgeries were performed by 8 residents in our department, always oversaw by the same assistant. We have analyzed age, gender, pathological staging, type of diversion used, surgical time, need for blood transfusion and blood volume used during surgery, immediate complications (1 to 30 days), late complications, and follow-up time.

Results: There were 51 men and 8 women. Mean age was 61.3 years (28 to 89), and the majority of the group was over 60 years (60%). Mean follow-up time was 8.5 months (3 to 36). Camey II ileal neobladder was used in 36 (62%) cases, ureterosigmoidostomy in 8 (13.8%), Bricker in 12 (20.7%), and Mainz-Pouch II diversion in 2 (3.5%) cases. Blood transfusion was required in 25 (42%) cases. Immediate complications were observed in 19% of the patients, and late complications in 19% as well.

Conclusion: When oversaw by an experienced surgeon, a resident gathers the conditions to perform a radical cystectomy, without significant increase in complication rates.