Open radical cystectomy is a reliable surgery with acceptable complication rates in elderly male patients: a retrospective, tertiary hospital-based study.

Objective: This study aims to evaluate safety of radical cystectomy (RS)+pelvic lymph node dissection (PLND)+ileal conduit urinary diversion (ICUD) in male patients aged >65 years versus ≤65 years.Materials and Methods: Eighty-five male patients who underwent RS + PLND + ICUD for bladder cancer were retrospectively analyzed. The patients were divided into two groups according to age: ≤65 years (Group 1, n = 40) versus >65 years (Group 2, n = 45). Data including baseline demographic and clinical characteristics of the patients, length of hospital stay, and complications within 90 days of surgery, and Grade ≤ II and Grade ≥ III complications according to the Clavien-Dindo (C-D) classification were recorded. Groups were compared in terms of demographic features and development of complications within 90 day after surgery statistically.Results: The median length of hospital stay was statistically significantly longer in Group 2 than Group 1 [10 (7-17) days vs. 9 (6-14) days, respectively; p < .05]. There was no statistically significant difference in the rehospitalization rate within 90 days of surgery between the groups (p > .05).Conclusion: Our study results suggest that RS + PLND + ICUD is a safe procedure in male patients aged ≥65 years.

Estudio prospectivo comparativo entre cistectomía radical laparoscópica y abierta: resultados operatorios y oncológicos / Prospective study comparing laparoscopic and open radical cystectomy: Surgical and oncological results

Introducción La cistectomía radical laparoscópica con linfadenectomía y derivación urinaria es una cirugía de empleo creciente. Se necesitan estudios que avalen la efectividad oncológica y la seguridad de este abordaje mínimamente invasivo. Pacientes y métodos: Estudio prospectivo comparativo no aleatorizado entre cistectomía radical abierta (CRA) y laparoscópica (CRL) llevado a cabo en un hospital universitario. El objetivo principal fue comparar la supervivencia cáncer-específica, y el objetivo secundario comparar resultados operatorios y complicaciones según la escala Clavien-Dindo. Resultados: Ciento cincuenta y seis pacientes con cáncer vesical invasivo de alto grado fueron tratados mediante CRA (n = 70) o CRL (n = 86). El seguimiento medio fue 33,5 ± 23,8 (rango 12-96) meses. La edad media fue 66,9 + 9,4 años y la proporción hombre/mujer 19:1. Ambos grupos fueron equivalentes en edad, estadio, ganglios positivos, carcinoma in situ, uropatía obstructiva preoperatoria, quimioterapia adyuvante y tipo de derivación urinaria. No hubo diferencias entre grupos en supervivencia cáncer-específica (log-rank; p = 0,71). El estadio histopatológico fue la única variable independiente predictiva de pronóstico. La estancia hospitalaria (p = 0,01) y la tasa de transfusión operatoria (p = 0,002) fueron menores para CRL. La duración de la cirugía fue mayor para CRL (p < 0,001). No hubo diferencias en la tasa de complicaciones totales (p = 0,62) ni complicaciones mayores (p = 0,69). El riesgo de evisceración (p = 0,02), infección de herida quirúrgica (p = 0,005) y neumonía (p = 0,017) fue mayor en CRA. El riesgo de lesión rectal (p = 0,017) y fístula uretrorrectal (p = 0,065) fue mayor en CRL. Conclusión: La CRL es un tratamiento equivalente a la CRA en términos de eficacia oncológica, y ventajoso respecto a tasa de transfusión y estancia hospitalaria, pero no respecto a la ocupación de quirófano o a la seguridad global. Se necesitan estudios que definan mejor el perfil de seguridad específico de cada abordaje

Introduction: Laparoscopic radical cystectomy with lymphadenectomy and urinary diversion is an increasingly widespread operation. Studies are needed to support the oncological effectiveness and safety of this minimally invasive approach. Patients and methods: A nonrandomised, comparative prospective study between open radical cystectomy (ORC) and laparoscopic radical cystectomy (LRC) was conducted in a university hospital. The main objective was to compare cancer-specific survival. The secondary objective was to compare the surgical results and complications according to the Clavien-Dindo scale. Results: We treated 156 patients with high-grade invasive bladder cancer with either ORC (n = 70) or LRC (n = 86). The mean follow-up was 33.5 ± 23.8 (range 12-96) months. The mean age was 66.9 + 9.4 years, and the male to female ratio was 19:1. Both groups were equivalent in age, stage, positive lymph nodes, in situ carcinoma, preoperative obstructive uropathy, adjuvant chemotherapy and type of urinary diversion. There were no differences between the groups in terms of cancer-specific survival (log-rank; P = .71). The histopathology stage was the only independent variable that predicted the prognosis. The hospital stay (P = .01) and operative transfusion rates (P = .002) were less for LRC. The duration of the surgery was greater for LRC (P < .001). There were no differences in the total complications rate (p = .62) or major complications (P = .69). The risk of evisceration (P = .02), surgical wound infection (P=.005) and pneumonia (P = .017) was greater for ORC. The risk of rectal lesion (P = .017) and urethrorectal fistulae (P = .065) was greater for LRC. Conclusion: LRC is an equivalent treatment to ORC in terms of oncological efficacy and is advantageous in terms of transfusion rates and hospital stays but not in terms of operating room time and overall safety. Studies are needed to better define the specific safety profile for each approach

Partial cystectomy and bilateral ureteroneocystostomy for resection of invasive transitional cell carcinoma involving the trigone area of the bladder in a dog - case report / Cistectomia parcial e uretroneocistostomia bilateral para ressecção de carcinoma invasivo de células de transição envolvendo área trigonal de bexiga em cão - relato de caso

This study aims to report the technique of partial cystectomy and bilateral ureteral reimplantation for resection of transitional cell carcinoma (TCC) in the trigone region of the bladder and the long-term follow-up in a Bernesse Mountain dog. The proposed surgical technique was considered viable and a potential treatment option for TCC in bladder trigone, with benefits regarding the prevention of urinary tract obstruction due to neoplastic growth and local removal of the primary tumor, which may limit or delay the spread of the disease even without adjuvant chemotherapy. The main disadvantages related to the described technique are ureteral stricture, intermittent cystitis and local relapse. However, the results are acceptable considering the long-term survival of 610 days in the case described.(AU)

Esse estudo tem como objetivo relatar a técnica de cistectomia parcial e reimplantação uretral bilateral para ressecção de carcinoma de células de transição em região trigonal de bexiga e seguimento clínico de cão da raça Bernesse Mountain. A técnica cirúrgica proposta foi considerada viável e opção potencial de tratamento com benefícios na prevenção de obstrução de trato uretral devido a crescimento neoplásico e remoção local de tumor primário que pode limitar ou retardar a disseminação da doença mesmo sem quimioterapia adjuvante. A principal desvantagem relatada em relação à técnica descrita são constrição uretral, cistite intermitente, e relapso local. No entanto, os resultados são aceitáveis levando em consideração a sobrevida a longo prazo de 610 no caso descrito.(AU)

[Representation of cystectomy and urinary diversion in the G-DRG system 2010: an example for the complexity of the reimbursement system]. / Kodierung der Zystektomie im DRG-System 2010 : Ein Beispiel für die Komplexität des Abrechnungssystems.

Cystectomy and urinary diversion is an excellent example for the growing complexity of the G-DRG (German diagnosis-related groups) system. Based on different diagnoses (malignant tumor of the urinary tract, benign disease of the urinary tract, malignant tumor of the female genital tract, or malignant tumor of the male genital tract), identical cases may lead to very different codes, resulting in even more differences in reimbursement.