Prakash R. Neupane, Ph, D, Surgical Oncology, B P Koirala Memorial Cancer Hospital, Yagyapuri,, Bharatpur municipality, ward no 7, Bharatpur, Nepal
Objective: Cancer of urinary bladder happens to be most common urological malignancy. Its management involves multidisciplinary approach depending upon the stage of the disease. Radical cystectomy is the one of the most complicated procedure in urological surgery. In the past, both morbidity and mortality were very leading to skepticism about radical cystectomy. Methods: In this presentation, we retrospectively analyzed urinary bladder cancer cases that underwent radical /total cystectomy at BPKMCH from October 1999 to October 2004 . Results: Out of 129 patients, 47 cases underwent total/radical cystectomy. Forty were males and 7 females. Age ranged from 32 to 77 years, among which 40 patients were above 50 years of age. Patients had history of hematuria for 3 months to 10 years. Many of them had undergone some mode of treatment before they presented to us. Average operation time was 6 hour and 30 minutes. Average blood loss during surgery was 1340 ml. Average postoperative hospital stay was 22 days. Most common intraoperative complication was bleeding (3 cases bleeding >2000ml), prolonged ileus & superficial wound infection; and there were three peri-operative mortality. Out of 47 cases, 41 were transitional cell carcinoma, 4 squamous cell carcinoma and 2 leiomyosarcomas. Radical cystectomy is a curative or salvage surgery performed for carcinoma urinary bladder. With improved techniques & experiences the complication rate can be reduced to acceptable levels and this operation is being performed routinely in our set-ups.
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