Peri-Operative Morbidity and Outcomes of Radical Cystectomy- Institutional Experience of Single Center

  • Amit Mani Upadhyay
  • Ashok Kumar Kunwar
  • Manik Lama
  • Kabir Tiwari
  • Sanjesh Bhakta Shrestha
  • Anil K Shah
  • Bishnu Dutta Poudel
  • Kapendra Shekhar Amatya
Keywords: Ileal Conduit, Muscle Invasive Bladder Cancer, Neo-bladder, Perioperative Morbidity, Radical Cystectomy


Introduction: The incidence of urinary bladder carcinoma increases distinctly with increasing age. Radical
cystectomy has been the gold standard for the treatment of patients with muscle-invasive bladder cancer or
recurrent high-grade non-muscle invasive bladder cancer. Our study aimed to see the peri-operative morbidity and
surgical outcomes of the patient who had undergone radical cystectomy in our low volume center.
Methods: We retrospectively reviewed the inpatient charts as well as the outpatient records of 10 patients who
had undergone radical cystectomy performed in our center for 9 years. A review of the literature on perioperative
morbidity of radical cystectomy was also done using the combination of keywords like mortality, complications,
and outcomes of surgery.
Results: Age of the patients ranged from 40-80 years. Eight of them were male and two were female. Painless
hematuria (70%) was the commonest presenting symptom, 80% of them were smokers. Three patients received
neoadjuvant chemotherapy. Nine patients had radical cystectomy with an ileal conduit, whereas one patient had
radical cystectomy with orthotopic neo-bladder.In postoperative complications, five patients had Clavien-Dindo
grade I, three patients had grade II, one patient had grade IIIB and one patient had grade V complications. Two
years of cancer-free survival was 90% and five years of cancer-free survival was 50%.
Conclusions: Radical cystectomy with ileal conduit was still the choice of surgery in muscle-invasive and recurrent
high-grade non-muscle invasive bladder cancer.