Archivos espanoles de urologia · 2007
[Acute peritonitis after radical cystectomy. Experience at our hospital and bibliographic review].
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Navarro Gil Joaquin, Sánchez Zalabardo José Manuel, Salinas Payer José Carlos, Bustamante Rodríguez Raquel, Valdivia Uría José Gabriel
Аннотация
OBJECTIVES: The characteristics of the patients may favour the appearance of complications. Taking into account the high morbimortality of the process, we believe that is convenient knowing main features of acute peritonitis in postoperatory in our surgical area.
METHODS: We have retrospectively studied the radical cystectomies having postoperative peritonitis. Variables considered can be classified in four main categories: patient physiology, operation, peritonitis and morbimortality.
RESULTS: During considered time, 9 of 80 cystectomies showed complications related with peritonitis (11,25%). Except one patient, 44-year-old, all others where 50-year-old or older males. 5 surgeries were curative and 4 palliative. 5 of the peritonitis appeared during first week. Initial mechanism was dehiscence, necrosis or hypertension (6.2 and 1 respectivelly). In 6 patients, origin was ureteroileal anastomosis, 2 intestinal anastomosis and I cutaneous ureterostomy. 3 of 9 patients died due to peritonitis.
CONCLUSIONS: The incidence of intra-abdominal complications during the immediate post operative period of radical cystectomy is high and, often, difficult to diagnose. In patients subjected to this surgery as a palliative method, possibility of showing complications is higher. To correct this medical profile, early intervention is fundamental, determining patient prognosis.
METHODS: We have retrospectively studied the radical cystectomies having postoperative peritonitis. Variables considered can be classified in four main categories: patient physiology, operation, peritonitis and morbimortality.
RESULTS: During considered time, 9 of 80 cystectomies showed complications related with peritonitis (11,25%). Except one patient, 44-year-old, all others where 50-year-old or older males. 5 surgeries were curative and 4 palliative. 5 of the peritonitis appeared during first week. Initial mechanism was dehiscence, necrosis or hypertension (6.2 and 1 respectivelly). In 6 patients, origin was ureteroileal anastomosis, 2 intestinal anastomosis and I cutaneous ureterostomy. 3 of 9 patients died due to peritonitis.
CONCLUSIONS: The incidence of intra-abdominal complications during the immediate post operative period of radical cystectomy is high and, often, difficult to diagnose. In patients subjected to this surgery as a palliative method, possibility of showing complications is higher. To correct this medical profile, early intervention is fundamental, determining patient prognosis.