Radical Cystectomies at the University Teaching Hospital, Lusaka: Baseline Characteristics, Short-term Complications, and Role of Nursing Care
Abstract:
Bladder cancer is the ninth most common cancer in the world and the 11th most common cancer in Zambia. Bladder cancer is of three histological types, Squamous cell cancer, Transitional cell cancer, and Adenocarcinoma. The most common histological type in Zambia is Squamous cell cancer accounting for 60 percent of cases of muscle-invasive bladder cancer. The treatment of muscle-invasive bladder cancer is radical cystectomy, Lymph node dissection, and urinary diversion. Globally, radical cystectomy is associated with high morbidity and mortality. The most common diversion used was uretero-sigmoidostomy, accounting for 60 percent of cases. In our case series, the most common complications were wound dehiscence, hypo-proteinemia, bowel ileus, deep vein thrombosis, and electrolyte imbalance. Identification and prevention of complications associated with this procedure play a crucial role in improving survival for these patients. The role of nursing staff in the early recognition of these complications cannot be overemphasized.References:
[1] Bray F., Ferlay J., Soerjomataram
I., Siegel R.L., Torre L.A., Jemal A.,2018, Global cancer statistics 2018:
GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries.
CA Cancer J. Clin. 2018; 68:394–424. doi: 10.3322/caac.21492.
[2] National Cancer Registry of Zambia, 2018, Zambia Global
Cancer observatory, https://gco.iarc.fr/today/home.
[3] Mapulanga, V., Labib, M., & Bowa, K.
2012. Pattern of Bladder Cancer at University Teaching Hospital, Lusaka, Zambia
in the era of HIV Epidemic. Medical Journal of Zambia, 39(1), 22-26.
[4] National Collaborating Centre for Cancer
(UK).,2015, Bladder Cancer: Diagnosis and Management. London: National Institute
for Health and Care Excellence (UK); 2015 Feb. (NICE Guideline, No. 2.) 5, Managing
muscle-invasive bladder cancer.
[5] Bowa K, Mulele C, Kachimba J, Manda E, Mapulanga
V, Mukosai S. ,2020, A review of bladder cancer in Sub-Saharan Africa: A different
disease, with a distinct presentation, assessment, and treatment. Ann Afr Med.
2018;17(3):99-105. doi:
10.4103/aam.aam_48_17.
[6] Stein, R., Hohenfellner, M., Pahernik,
S., Roth, S., Thüroff, J. W., & Rübben, H.,2012, Urinary diversion--approaches
and consequences. Deutsches Arzteblatt international, 109(38), 617–622.
https://doi.org/10.3238/arztebl.2012.0617.
[7] Anderson CB, McKiernan
JM.,2018, Surgical Complications of Urinary Diversion. Urol Clin North Am. 2018
Feb;45(1):79-90.
[8] Nazmy M, Yuh B, Kawachi M, Lau
CS, Linehan J, Ruel NH, Torrey RR, Yamzon J, Wilson TG, Chan KG.,2014, Early and late complications of robot-assisted
radical cystectomy: a standardized analysis by urinary diversion type. J Urol.
2014 Mar;191(3):681-7.
[9] Hautmann RE, de Petriconi
RC, Volkmer BG., 2010, Lessons learned from 1,000 neobladders: the 90-day complication
rate. J Urol. 2010 Sep;184(3):990-4; quiz 1235.
[10] Schomburg J, Krishna S,
Soubra A, Cotter K, Fan Y, Brown G, Konety B.,2018, Extended outpatient chemoprophylaxis
reduces venous thromboembolism after radical cystectomy. Urol Oncol. 2018 Feb;36(2):77.
e9-77. e13.