POST OPERATIVE CLINICAL OUTCOME IN PATIENTS 75 YEARS OLD AND OLDER TREATED WITH RADICAL CYSTECTOMY
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OBJECTIVE :
We have reviewed post operative complications, morbidity and clinic outcome in 34 patients 75 years old and older who were treated with radical cystectomy and urinary diversion in our Hospital from 2009 to 2013.
METHODS:
Between January 2009 and dicember 2013, of 93 patients who underwent radical cystectomy, 30 men and 5 women were aged from 75 to 84 (median 79.59 years. Urinary diversion (25 UCS and 8 Bricker) was performed in 33 cases and bladder substitution in 2. All patients had significant co-morbidity: 6 patients were ASA II, 22 were ASA III and 7 ASA IV. The median value of pre operatory hemoglobin were 11.65, of the albumin were 3.26 (5 patients had Hb < 10 g/dl and 3 patients had albumin value < 3.0 g/dl.
RESULTS:
Median operating was 225 minutes. Peri-operative mortality rate was 0%. Early post-operative complications occurred in 17 patients (50%). The most common early complications were problems of surgical wound (41%), disorientations (15%), dyspnea (14%), prolonged ileus ( 11%), heart cardiology and I.R.A.(8%). No secondary procedures were necessary. 9 patients (26%) had hypoalbuminemia marked (<2,6 g/dl).
CONCLUSIONS:
Radical cystectomy can be performed in elderly patients with acceptable peri-operative mortality and morbidity. However, because of the high incidence of minor medical complications, hospital stay is often prolonged, and significantly higher in patients with complications.
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