| Summary: | Background/Aim. Radical cystectomy is the method of choice for the treatment
of muscle invasive bladder cancer. This major surgery is associated with many
complications, especially in older patients. The aim of this study was to
analyze preoperative comorbidity, and intraoperative and postoperative
complicatons in patients older than 75 years. Methods. This clinical,
retrospective study included 46 patients over 75 years, who underwent radical
cystectomy. Indications for surgery, and complications during and after the
surgery were followed up. Results. Preoperatively, anemia caused by hematuria
was registered in 76% of the patients. In 52% of the patients urine
derivation was performed by ileal conduit, in 35% by ureterocutaneostomy and
in 13% orthotopic ileal neobladder was created. The average duration of
surgery was 190 (120-300) min. A total of 76% of the patients were treated by
blood supstitution intraoperatively, average 630 (310-1230) mL. Concerning
pathological stage of transitional cell carcinoma of urinary bladder, 26% of
the patients had T2, 4% T3a, 52% T3b, and 14% T4a stage. In one case,
planocellular carcinoma was diagnosed by patohistological examination, and in
2 cases prostate carcinoma was incidentally found. The average duration of
hospitalization was 16 (8-35) days. Conclusion. The main reason for
cystectomy in patients over 70 and 80 years was gross hematuria caused by
bladder cancer, with consecutive anemia which could not be solved using
endoscopic treatment or blood supstitution. As expected, a prolonged stay in
hospital after cystectomy, and a higher rate of complications were recorded
in this population.
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