Orthotopic neobladder reconstruction in elderly bladder cancer patients
| Autor: | Tomoyasu Tsushima, Bunzo Suyama, Yasutomo Nasu, Takashi Saika, Tadashi Murata, Daisuke Manabe, Takushi Kurashige, Hiromi Kumon |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
medicine.medical_specialty Urology medicine.medical_treatment media_common.quotation_subject Urinary Diversion Cystectomy Urination Metastasis Stoma Postoperative Complications medicine Humans Aged media_common Aged 80 and over Bladder cancer business.industry Urinary Reservoirs Continent Significant difference Urinary diversion Age Factors Length of Stay Middle Aged Prognosis medicine.disease Surgery Urinary Bladder Neoplasms Female Neoplasm Recurrence Local business Complication Follow-Up Studies |
| Zdroj: | International Journal of Urology. 8:533-538 |
| ISSN: | 1442-2042 0919-8172 |
| Popis: | Background: We compared the clinical results of orthotopic neobladder reconstruction in elderly patients and those in younger patients retrospectively in order to verify whether age is a critical factor in selecting a method of urinary diversion. Methods: Following radical cystectomy for bladder cancer, 12 patients aged 75 or older and 17 patients under 75 who underwent orthotopic neobladder reconstruction between January 1992 and May 1999 were investigated in this study. The authors TS and BS were among the surgeons who performed operations for all cases. Of the 12 elderly patients, orthotopic neobladders were constructed according to Hautmann's method in nine cases, Studer's method in one case and Reddy's method in two cases. Of the 17 younger patients, these methods were employed in 12, one and four cases, respectively. Operative procedure, early and late complications, prognosis, continence and voiding pattern were investigated in these patients. Results: The follow-up periods for elderly and younger groups ranged from 21.3 to 82.7 months and from 8.8 to 94.2 months, respectively. No difference in operation time, amount of bleeding or postoperative length of hospitalization was observed between elderly and younger patients. The rates of early complications in elderly and younger patients were 41.7% and 35.3%, respectively. Late complication rates were 33.3% and 47.1%, respectively. The difference in these complication rates was not statistically significant. One of the elderly and two of the younger patients had local recurrence and metastasis postoperatively. Those three patients had died of their bladder cancer. No statistically significant difference between groups was recognized in either cause-specific survival or overall survival, nor was there such a difference in relation to micturition/continence. Conclusion: Based on these results, we believe that because age is not a critical factor in the selection of urinary diversion method, neobladder reconstruction following cystectomy for bladder cancer is indicated in elderly patients. As stoma management is difficult for the patients, we consider orthotopic neobladder reconstruction to be the method of choice if the patients' general physical condition allows. |
| Databáze: | OpenAIRE |
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