[Laparoscopic radical cystectomy in elderly patients with bladder cancer: feasibility and evaluation of morbidity].
OBJECTIVE
To evaluate the feasibility and morbidity and mortality of laparoscopic radical cystectomy for bladder cancer in elderly patients.


METHODS
Prospective study conducted between January 2003 and May 2009 in 22 patients, one woman and 21 men, who underwent laparoscopic radical cystectomy for bladder cancer. Mean patient age was 76.2+/-4.3 years. The median preoperative ASA score was 2 (1-3). The indication for surgery was an invasive muscle bladder tumour in 18 cases and noninvasive muscle bladder cancer refractory to conservative treatment (chemotherapy, immunotherapy) in four cases. Ileal conduit was carried out in 15 cases. An ileal neobladder was fashioned in six cases using Camey's technique. One bilateral cutaneous ureterostomy was performed.


RESULTS
There was one conversion to open surgery. One intraoperative complication was noted (left obturator nerve injury). Mean blood loss was 377.5+/-341.2ml. No perioperative death was observed. Mean time to resumption of oral fluids was 2.4+/-1.6 days and mean time to resumption of solids was 4.5+/-1.6 days. Mean time to resumption of bowel movements was 3.9+/-1.9 days. Mean critical care unit was 4.2+/-1.4 days. Five patients (22.7 %) had postoperative complications. Postoperative narcotic analgesics were necessary in 60 % of cases. Mean hospital stay was 11.0+/-3.0 days. Mean patient follow-up was 46.4+/-20.8 months.


CONCLUSIONS
Laparoscopic radical cystectomy for bladder cancer in elderly patients is associated with low morbidity, and a limited hospital stay.
Service d'urologie, d'andrologie et de transplantation rénale, CHU Rangueil, 1, avenue du Pr-Jean-Poulhès, TSA 50032, 31059 Toulouse cedex, France. julienguillotreau@hotmail.fr
J
J
Guillotreau
X
X
Gamé
M
M
Mouzin
J-B
JB
Roche
S
S
Abu Anz
N
N
Doumerc
F
F
Sallusto
B
B
Malavaud
P
P
Rischmann
D000368:Aged; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008297:Male; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D001749:Urinary Bladder Neoplasms / Q000601:surgery*
Cystectomie radicale coelioscopique pour cancer de vessie, chez les sujets de plus de 70ans : faisabilité et étude de la morbidité