Buenos Aires, Argentina (UroToday.com) Matthew Young from Pinderfields General Hospital, UK assessed RC among elderly patients. Eighty one patients were assessed from 2013-2015 and divided into those < or > 75 years of age.
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Of note 68 (84%) patients underwent laparoscopic radical cystectomy (unknown how many had intracorporeal ileal conduit). There was no difference in comorbidity between the two cohorts and no difference in hospital stay (10 days) or complications as assessed by the Clavien system. Thirty day mortality was 4% and 6.6%, respectively. While the authors concluded RC may be performed safely in patients older than 75 years of age, the present results need to be taken into the context of their findings. First, majority of patients underwent laparoscopic RC and unknown regarding how many underwent intracorporeal diversion. Second, it remains unclear if any early recovery after surgery (ERAS) protocol was used but the answer is likely no given the median hospital stay being 10 days. ERAS is critical taking account perioperative morbidity as well as shortening the hospital stay. Third, laparoscopic RC is significantly underused as compared to open RC and further operative data including surgeon volume, operative time, fluids administered among others are needed to carefully interpret these findings.
World Urological Oncology Federation Symposium at the SIU Congress 2016 - October 20 - 23, 2016 – Buenos Aires, Argentina
Written By: Stephen B. Williams, M.D., Assistant Professor in Urology, The University of Texas Medical Branch, Galveston, TX. and Ashish Kamat, M.D. Professor, Department of Urology, Division of Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.