title: Laparoscopic Versus Open Radical Cystectomy for Patients Older than 75 Years: a Single-Center Comparative Analysis.
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.
  
  
  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.
authors.affiliation: Department of Nephro-urology, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan E-mail : yasui@med.nagoya-cu.ac.jp.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yasui
authors.forename: Keiichi
authors.initials: K
authors.lastname: Tozawa
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Ando
authors.forename: Takashi
authors.initials: T
authors.lastname: Hamakawa
authors.forename: Shoichiro
authors.initials: S
authors.lastname: Iwatsuki
authors.forename: Kazumi
authors.initials: K
authors.lastname: Taguchi
authors.forename: Daichi
authors.initials: D
authors.lastname: Kobayashi
authors.forename: Taku
authors.initials: T
authors.lastname: Naiki
authors.forename: Kentaro
authors.initials: K
authors.lastname: Mizuno
authors.forename: Atsushi
authors.initials: A
authors.lastname: Okada
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Umemoto
authors.forename: Noriyasu
authors.initials: N
authors.lastname: Kawai
authors.forename: Shoichi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Yutaro
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kohri
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D045823:Ileus / Q000209:etiology; D007239:Infections / Q000209:etiology; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D012189:Retrospective Studies; D015996:Survival Rate; D001749:Urinary Bladder Neoplasms / Q000601:surgery*