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Objective: To review the complications of mortality rate after radical cystectomy in Ramathibodi Hospital and analysis for the possible contributing factors to the outcome after the procedure.
Methods: All patients who underwent radical cystectomy with urinary diversion between January 2005 to December 2011 were retrospectively reviewed. Preoperative patient characteristics and preoperative data were recorded. Perioperative morbidity and mortality within 90 days after surgery were analyzed for the possible contributing factors with univariate and multivariate analysis.
Results: Of all 106 patients, 90 men and 16 women, with mean age of 65.6 year (33 - 88 years). Postoperative complications within 90 days were observed in 38 (35.5%) of the patients, the most common complication being sepsis 17 (16.0%) cases, followed by wound infection/dehiscence 12 (11.3%) cases and urine leak/collection 6 (5.6%) cases. The 90-d mortality rate was 8.4%. Age was the only factor that significantly affected perioperative and mortality.
Conclusions: Although age more than 70 years significantly affected perioperative morbidity and mortality, properly selected elderly patients who were reasonably in good health were found to be safe for radical cystectomy with urinary diversion for treatment of invasive bladder carcinoma patients.
Vaidya A, Soloway MS, Hawke C, Tiguert R, Civantos F. De novo muscle invasive bladder cancer: is there a change in trend? J Urol. 2001;165(1):47-50.
Ploeg M, Aben KK, Kiemeney LA. The present and future burden of urinary bladder cancer in the world. World J Urol. 2009;27(3):289-293. doi:10.1007/s00345-009-0383-3.
Marshall FF. Surgery of the bladder: in Walsh PC, Retik AB, Vaughan ED, Wein AJ (eds): Campbell’s Urology, ed 7. Philadelphiia, Saunder. 1998;3:3274-3297.
Hall MC, Swanson DA, Dinney CP. Complications of radical cystectomy: impact of the timing of perioperative chemotherapy. Urology. 1996;47(6):826-830.
Johnson DE, Lamy SM. Complications of a single stage radical cystectomy and ileal conduit diversion: review of 214 cases. J Urol. 1977;117:171-173.
Brannan W, Fuselier HA, Jr, Ochsner M, Randrup ER. Critical evaluation of 1-stage cystectomy--reducing morbidity and mortality. J Urol. 1981;125:640-642.
Skinner DG, Crawford ED, Kaufman JJ. Complications of radical cystectomy for carcinoma of the bladder. J Urol. 1980;123(5):640-643.
Frazier HA, Robertson JE, Paulson DF. Complications of radical cystectomy and urinary diversion: a retrospective review of 675 cases in 2 decades. J Urol. 1992;148(5):1401-1405.
Figueroa AJ, Stein JP, Dickinson M, et al. Radical cystectomy for elderly patients with bladder carcinoma: an updated experience with 404 patients. Cancer. 1998;83(1):141-147.
Montie JE, Wood DP. The risk of radical cystectomy. Br J Urol. 1989;63:483-486.