Morbidity and mortality of radical cystectomy (1971-78 and 1978-85)

The mortality after radical cystectomy with urinary diversion has been reduced from 11% in 53 patients operated on during 1971-78, to 2.5% in a similar group of 120 patients operated on during 1978-85. Amongst the latter, mortality varied from 0 amongst 32 non-irradiated patients, to 1 (3%) of 33 after planned preoperative radiotherapy and 2 (3.6%) of 55 after previous radical radiotherapy. The improvement in results appears to be due to a number of factors including routine intensive care in the early postoperative phase, with epidural analgesia, and meticulous attention to haemostasis and the technical details of construction of the ileal conduit.