Outcome of radical cystectomy in remote area of Pakistan: Recep Tayyip Erdogan Hospital, Muzaffargarh

Original Article

Abstract

Background: Radical cystectomy with bilateral pelvic lymphadenectomy is the standard treatment for high-grade/muscle-invasive urinary bladder tumors. Continent or incontinent urinary diversion is part of this major operation. High-volume centers perform routinely, but low-volume centers do less frequently. It might be because of the availability of equipment and trained surgeons in remote areas of Pakistan.

Objectives: to assess the results of radical cystectomy at a low-volume center for high-grade muscle-invasive bladder tumors. For patients aged 50 to 75, this involves evaluating surgical complications, overall survival, and the absence of tumor recurrence throughout a one-year follow-up period.

Study Design: A Retrospective Study

Duration and place of study: Department of Urology Recep Tayyip Endogen Hospital Muzaffargarh, from October 2018 to August 2022

Methods: Out of both genders and 50 to 75 years old with grade/ Muscle invasive urinary bladder carcinoma, incomplete resection during TURBT due to high volume of mass (irresistible) included. Performa is designed for the collection of information. All the patients underwent the same Procedure by the same urologist. Patients were followed for one year after surgery.

Results: All participants were followed for one year. 33.3% of patients had paralytic ileus (CDC I), 13.3% had wound infection(CDC I), and 6.7% had urinary leakage (CDC IIIb). There was an overall survival rate of 86.6%. 6.7% were lost to follow-up. The mean operative time was 308 ±95 minutes. No recurrence was noted throughout the study period.

Conclusion: Good operative results can also be achieved at low-volume centers. A high level of surveillance and expertise helps to achieve better outcomes in remote settings.

Keywords: cystectomy, radical cystectomy, bladder tumor, ideal conduit