Introduction: Venous thromboembolic (VTE) complications pose significant risk for patients undergoing pelvic oncologic procedures, including radical cystectomy. We sought to describe the prevalence of VTE after robot-assisted radical cystectomy (RARC) at our institution, and further describe associated variables.
Methods: A retrospective review of the prospectively maintained departmental database (2005-2019) included 639 patients. Patients were divided into those who developed VTE [deep venous thrombosis (DVT) and pulmonary embolism (PE)] and those who did not. Baseline demographic, disease characteristics and perioperative outcomes were compared. The Kaplan-Meier method was used to depict overall survival (OS). Multivariate logistic regression analysis was used to identify variables associated with VTE.
Results: 55 patients (9%) developed VTE (23 developed DVT and 31 developed PE. Median time to DVT was 31 days and median time to PE was 37 days.The rate of VTE remained stable between 2005 and 2019. VTE was not fatal in any patient. Patients who developed VTE had significantly higher BMI (31 vs 29, p= 0.03), =cT3 (19% vs 9%, p= 0.03) and cN+ (20% vs 10%, p= 0.05) more frequently. They had longer inpatient stay (9 vs 7 days, p< 0.01), =pT3 (60% vs 38%, p< 0.01), and reoperations within 30 days (13% vs 4%, p= 0.02) more frequently (Table 1a). Patients with VTE had significantly higher high grade complications other than VTE (55% vs 33%, p< 0.01) and readmissions (71% vs 35%, p< 0.01). Patients with VTE exhibited similar OS to patients who did not develop VTE (p= 0.20). Multivariate analysis showed that BMI (OR 1.04; 95% CI 1.01-1.08; p= 0.03), = pT3 (OR 2.54; 95% CI 1.42-4.52; p< 0.01), and length of hospital stay (OR 1.04; 95% CI 1.02-1.07; p< 0.01) were associated with VTE post RARC (Table 1b).
Conclusions: VTE remains a major complication after RARC, but incidence remained stable over time. BMI, disease stage, and prolonged inpatient stay were associated with VTE. Source of