Complications after transurethral resection of bladder tumor: Findings from the 2022 ACS NSQIP database.

Abstract

742 Background: Transurethral resection of bladder tumor (TURBT) is a widely utilized procedure for the diagnosis and treatment of bladder cancer (BC). Despite its well-established role, TURBT is associated with a relatively high rate of postprocedural complications. This study aimed to provide an update on the most prevalent complications following TURBT, using data from the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) 2022 database. Methods: The ACS NSQIP 2022 database was queried for all patients who underwent TURBT. Current Procedure Terminology (CPT) codes 52234, 52235, and 52240 were used to identify size-specific TURBTs. Standard statistical analysis using R version 4.4.1 was performed to determine complications. Results: A total of 9,448 TURBTs were included in our analysis. Median age was 73 years old (IQR: 58-88), 2,315 females and 7132 males that received a TURBT within the cohort. Patients with concurrent procedures were removed from the final analyses, but those who received intravesical chemotherapy or underwent concurrent ureteroscopy were retained. The overall complication rate of TURBT was 8.04% in 2022. Postprocedural urinary tract infection (UTI) - within 30 days after TURBT - was the most common complication, accounting for 4.5% of total complications. 160 patients or 1.7% were found with more than one complication. There were no significant differences in complications by age or sex (p = 0.129 and p = 0.124); however larger tumors were related to higher likelihood of post-operative complications. Conclusions: Serious adverse complications after TURBT are rare and TURBTs are generally a safe procedure. However, the ACS NSQIP database suggests that postprocedural UTI are the most common but the rate may be marginally higher than previously reported in TURBT patients. The key limitation of this study was the inability to report the most serious complications of TURBT – i.e. bladder perforation and TUR syndrome – due to NSQIP database’s inability to capture detailed case-specific data. More detailed studies assessing patient-reported outcomes may provide a better method to evaluate the types of complications following TURBT. 30-day complications after TURBT in 2022. 30-day Complications Frequency Percentage Acute Renal Failure 4 0.043% Cardiac Arrest Requiring CPR 10 0.108% Still in Hospital after 30 days 15 0.161% Stroke/CVA 22 0.237% Pneumonia 31 0.333% DVT/PE/Thrombophlebitis 48 0.508% Transfusions Required 122 1.312% Progressive Renal Insufficiency 135 1.452% Related Reoperations within 30 days 148 1.592% Urinary Tract infections 430 4.603% Total 760 8.044%