Cystectomy and urinary diversion: a safe procedure for elderly patients

Cystectomy and urinary diversion have been done on 28 patients more than age seventy with a zero perioperative mortality. Nine female patients with an average age of 77.6 years and 19 male patients with an average age of 74.4 years with 3 patients being greater than age eighty, are the subject of this review. Complication rate, blood loss, and hospital stay were not significantly different from patients having cystectomy and urinary diversion who were seventy years of age or less. Twenty-seven of the 28 patients had muscle-invading tumors; 12 patients are alive with a median survival of greater than thirty months. Five of 10 patients who did not receive radiation therapy are alive; 7 of 18 patients who received some form of radiation therapy are alive. Six patients had been treated initially with 7,000 rad for definitive therapy of bladder carcinomas. In carefully selected patients, when appropriate attention is paid to general patient status, cardiovascular system, pulmonary function, and fluid and electrolyte status, cystectomy and diversion can be completed with an acceptable rate of morbidity.