title: Radical cystectomy in eldery.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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 treat- ment or blood supstitution. As expected, a prolonged stay in hospital after cystectomy, and a higher rate of complications were recorded in this population.
authors.forename: Vladimir
authors.initials: V
authors.lastname: Bancević
authors.forename: Predrag
authors.initials: P
authors.lastname: Aleksić
authors.forename: Novak
authors.initials: N
authors.lastname: Milović
authors.forename: Aleksandar
authors.initials: A
authors.lastname: Spasić
authors.forename: Bozidar
authors.initials: B
authors.lastname: Kovacević
authors.forename: Perica
authors.initials: P
authors.lastname: Tosevski
authors.forename: Zoran
authors.initials: Z
authors.lastname: Campara
authors.forename: Radovan
authors.initials: R
authors.lastname: Milosević
authors.forename: Snezana
authors.initials: S
authors.lastname: Cerović
mesh_terms: D000368:Aged; D015653:Cystectomy; D005260:Female; D006801:Humans; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications; D012189:Retrospective Studies; D001749:Urinary Bladder Neoplasms / Q000601:surgery