Abstract

Introduction: The incidence of urinary bladder carcinoma increases distinctly with increasing age. Radicalcystectomy has been the gold standard for the treatment of patients with muscle-invasive bladder cancer or recurrent high-grade non-muscle invasive bladder cancer. Our study aimed to see the peri-operative morbidity and surgical outcomes of the patient who had undergone radical cystectomy in our low volume center.
 Methods: We retrospectively reviewed the inpatient charts as well as the outpatient records of 10 patients who had undergone radical cystectomy performed in our center for 9 years. A review of the literature on perioperativemorbidity of radical cystectomy was also done using the combination of keywords like mortality, complications, and outcomes of surgery.
 Results: Age of the patients ranged from 40-80 years. Eight of them were male and two were female. Painlesshematuria (70%) was the commonest presenting symptom, 80% of them were smokers. Three patients received neoadjuvant chemotherapy. Nine patients had radical cystectomy with an ileal conduit, whereas one patient hadradical cystectomy with orthotropic neo-bladder. In postoperative complications, five patients had Clavien-Dindograde I, three patients had grade II, one patient had grade IIIB and one patient had grade V complications. Two years of cancer-free survival was 90% and five years of cancer-free survival was 50%.
 Conclusions: Radical cystectomy with ileal conduit was still the choice of surgery in muscle-invasive and recurrent high-grade non-muscle invasive bladder cancer.

Highlights

  • The incidence of urinary bladder carcinoma increases distinctly with increasing age

  • We aimed to evaluate the outcomes of radical cystectomy and its perioperative morbidity in our low volume center

  • We retrospectively reviewed the inpatient charts as well as outpatient records of ten patients who had undergone Radical Cystectomy (RC) performed in Kathmandu Model Hospital from January 2011 to December 2019 for 9 years

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Summary

Introduction

Radical cystectomy has been the gold standard for the treatment of patients with muscle-invasive bladder cancer or recurrent high-grade non-muscle invasive bladder cancer. The disease most commonly occurs beyond the age of 70 years of life.[1] Radical cystectomy(RC) remains the gold standard for treatment of patients with muscle-invasive bladder cancer or recurrent high-grade non-muscle invasive bladder cancer.[2] Despite the advent of minimally invasive and robotic technology, radical cystectomy has significant mortality and morbidity.[2] RC is a technically challenging operation and prompt post-operative recovery, short hospital stay, and reduction in morbidity and mortality are difficult to achieve.[1] The high rates of morbidity and mortality are because the majority of patients undergoing this procedure are elderly patients with multiple comorbidities.[2]

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