Clinically significant consequences of fascial dehiscence during radical cystectomy are possible. For a study, researchers aimed to describe the intraabdominal findings that occur alongside a dehiscence repair following a cystectomy and to answer the question of whether or not a comprehensive intraabdominal exploration is required for a successful repair. They looked back at data from individuals who had open radical cystectomies at multiple hospitals between 2005 and 2020. Within 30 days after having a cyst removed, patients who required exploratory surgery due to fascial dehiscence were included in the study. Information gathered included patient demographics, the clinical presentation of dehiscence, associated laboratory findings, imaging data, surgical parameters, operative findings, and clinical implications. Intraabdominal problems can occur, thus, they looked into what factors might indicate that they might occur. Cystectomy was performed on 1,301 patients, with 2% requiring dehiscence correction at a median of 7 days post-op. About 7 patients (26%), comprising a urine leak in 5 (19%), a fecal leak in 1 (4%), and an internal hernia in 1 (4%), were also diagnosed with additional intraabdominal diseases. Longer hospital stays (20 (IQR 17, 23) vs. 41 (IQR 29, 47) days, P=0.03) and later dehiscence detection (7 (IQR 5, 9) vs. 10 (IQR 6, 15) days postoperatively) were linked to the presence of accompanying intraabdominal abnormalities. There was no significant difference in the incidence of complications after an investigation between the 2 groups. The only significant predictor of further intraabdominal diseases was a history of ischemic heart disease (67% vs. 24%; P=0.02). Patients having post-cystectomy fascial dehiscence repair may be experiencing additional, undetected surgical consequences.
Source: bmcurol.biomedcentral.com/articles/10.1186/s12894-022-01095-4
