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Laparoscopic Versus Open Radical Cystectomy for Patients Older than 75 Years: a Single-Center Comparative Analysis

  • Yasui, Takahiro ;
  • Tozawa, Keiichi ;
  • Ando, Ryosuke ;
  • Hamakawa, Takashi ;
  • Iwatsuki, Shoichiro ;
  • Taguchi, Kazumi ;
  • Kobayashi, Daichi ;
  • Naiki, Taku ;
  • Mizuno, Kentaro ;
  • Okada, Atsushi ;
  • Umemoto, Yukihiro ;
  • Kawai, Noriyasu ;
  • Sasaki, Shoichi ;
  • Hayashi, Yutaro ;
  • Kohri, Kenjiro
  • Published : 2015.10.06

Abstract

Background: To explore the safety, efficacy, and oncological outcome of 3-port laparoscopic radical cystectomy (LRC) compared to open radical cystectomy (ORC) in patients older than 75 years. Materials and Methods: From June 2010 to July 2014, we analyzed 16 radical cystectomies in patients older than 75 years (LRC group=8; ORC group=8). Demographic parameters, operative variables, and perioperative outcome in the 2 groups were retrospectively collected, analyzed, and compared. Results: Patients in both groups had comparable preoperative characteristics. A significantly longer operating time (476 vs. 303 min, P=0.0002) and less estimated blood loss (627 vs. 2,106 mL, P=0.021) were observed in the LRC group compared to the ORC group. Infection and ileus were the most common early complications after surgery. Patients who underwent ORC suffered from more postoperative infection (22.2% vs. 0.0%, P=0.054) and ileus (25.0% vs. 12.5%, P=0.521) than the LRC group, but the difference was not significant. Conclusions: Judging from this initial trial, 3-port LRC can be safely carried out in elderly patients. We suggest 3-port LRC as the primary intervention to treat muscle-invasive or high-risk nonmuscle-invasive bladder cancer in elderly patients with an otherwise relatively long life expectancy.

Keywords

Laparoscopy;radical;cystectomy;older patients;bladder cancer

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