BACKGROUND: Cystectomy has a significant morbidity and mortality. P-POSSUM is a risk score that can predict postoperative morbimortality. The anaesthetic technique can be either combined or general. The postoperative evaluation is important to understand the quality of daily life. The purpose of this study is to evaluate: the postoperative morbidity and mortality with the P-POSSUM score; the intraoperative anesthetic technique regarding blood loss and blood products requirement and the postoperative quality of life with HRQOL questionnaire.  
MATERIAL AND METHODS: A retrospective analysis was performed at the Central Lisbon Hospital from October 2011 to September 2014. The P-POSSUM determination was based on 30 days morbidity (Clavien-Dindo scale) and mortality. The HRQOL questionnaire was done by a phone survey of 25 patients with a maximum of three attempts. 
RESULTS: 50 patients were analyzed, aged 62-78 years and with a majority of males (45/50) and ASA III (32/50). P-POSSUM had a higher estimation of morbidity and mortality. Combined anaesthesia was performed in 76.6% (38/50). It had a lower blood loss (p=0,522) and blood products requirement (p=0,494). A higher time of procedure was observed (p=0,295). 18 patients answered the HRQOL questionnaire. It showed an impact on activities of daily life with a greater expression at a professional level. 28% patients referred chronic pain associated to cystectomy.
CONCLUSIONS: A larger sample would be necessary to validate the P-POSSUM results and the real benefits of combined anaesthesia. This study led to an improvement in our multidisciplinary protocol in order to achieve better results in perioperative care in patients submitted to cystectomy.

12 / Cystectomy in a Central Lisbon Hospital: a 3 year experience