Detailed Analysis of Urinary Tract Infections After Robot-Assisted Radical Cystectomy

医学 膀胱切除术 四分位间距 优势比 泌尿系统 肾积水 泌尿科 外科 置信区间 尿路改道 回顾性队列研究 膀胱癌 多元分析 吻合 内科学 癌症
作者
Naif A. Aldhaam,Ahmed A. Hussein,Ahmed S. Elsayed,Zhe Jing,Jennifer Osei,Zachary Kurbiel,Tarik Babar,Sara Khan,Avneet Nagra,Brahm H. Segal,Qiang Li,Khurshid A. Guru
出处
期刊:Journal of Endourology [Mary Ann Liebert, Inc.]
卷期号:35 (1): 62-70 被引量:5
标识
DOI:10.1089/end.2020.0316
摘要

Objective: To describe urinary tract infections (UTIs) after robot-assisted radical cystectomy (RARC) and investigate the variables associated with it. Materials and Methods: A retrospective review of 616 patients who underwent RARC between 2005 and 2019 was performed. Patients were divided into those who developed UTI and those who did not. Patients who developed UTI were further subdivided into three subgroups according to the onset, number, and severity. The Kaplan–Meier method was used to depict time to UTI. Multivariate analysis was used to investigate variables associated with UTI. Result: Two hundred forty (39%) patients were diagnosed with UTI after RARC; 48% occurred within 30 days, 17% within 30–90 days, and 35% at 90 days after RARC. Twenty-three percent of the patients presented with urosepsis. The median (interquartile ratio) time to develop UTI was 1 (0.3–7) month. On multivariate analysis, patients who received neobladders (odds ratio [OR] 2.80; 95% confidence interval [CI] 1.50–5.20; p < 0.01), prolonged hospital stay (OR 1.06; 95% CI 1.03–1.08; p < 0.01), adjuvant chemotherapy (OR 2.20; 95% CI 1.40–3.60; p < 0.01), poor renal function postoperatively (OR 2.30; 95% CI 1.30–3.80; p < 0.01), postoperative hydronephrosis (OR 2.50; 95% CI 1.40–4.50; p < 0.01), ureteroileal anastomotic stricture (OR 2.90; 95% CI 1.50–5.70; p < 0.01), and stented ureteroileal anastomosis (OR 9.35; 95% CI 1.23–71.19; p = 0.03) were associated with UTI after RARC. Conclusion: UTI is common after RARC mainly within the first month after RARC. Enterococcus faecalis was the most common causative organism.
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