Abstract:
OBJECTIVE:To assess perioperative complications and 90-day mortality of radical cystectomy (RC) in elderly patients with muscle-invasive bladder cancer (MIBC). MATERIALS AND METHODS:This is a retrospective, multicentre (n = 11) study of a consecutive series of patients ≥75 years who underwent RC for MIBC between 2006 and 2010. Medical, surgical and wound complications were graded according to the modified Clavien-Dindo classification. RESULTS:A total of 256 patients with a mean age of 79.6 years (range 75.0-86.6) were analysed. Urinary diversion with the use of bowel was performed in 79.5% and ureterocutaneostomy in 20.5%, with a higher proportion in the ≥80 cohort (32.2 vs. 14%; p = 0.001). 41.4% of patients had an uneventful postoperative course (Clavien grade 0) and 26.6% developed severe complications (Clavien grade III-V). In a multivariable regression analysis, the Charlson comorbidity index (odds ratio 1.5 per unit increase; p < 0.001) and the body mass index (odds ratio 1.13 per kg/m(2) increase; p = 0.015) were predictors for the development of complications. The 90-day mortality rate was 9% and the independent correlates thereof were the development of severe medical complications (p = 0.004), the American Society of Anesthesiologists (ASA) score (p = 0.03) and age (p = 0.005). CONCLUSIONS:Morbidity and 90-day mortality of RC in the elderly remain substantial. The interrelation between comorbidity, complication rate and 90-day mortality underlines the need for a comprehensive geriatric assessment of elderly patients with MIBC in whom RC is indicated.
journal_name
Urol Intjournal_title
Urologia internationalisauthors
Berger I,Martini T,Wehrberger C,Comploj E,Ponholzer A,Wolfgang M,Breinl E,Dunzinger M,Hofbauer J,Höltl W,Jeschke K,Krause S,Kugler W,Pauer W,Rauchenwald M,Pycha A,Madersbacher Sdoi
10.1159/000357127subject
Has Abstractpub_date
2014-01-01 00:00:00pages
296-302issue
3eissn
0042-1138issn
1423-0399pii
000357127journal_volume
93pub_type
杂志文章,多中心研究abstract:OBJECTIVES:Endorectal coil MRI (endoMRI) of the prostate is useful to evaluate tumor localization. There is little evidence on patient characteristics affecting its diagnostic performance. We evaluate the influence of clinical and histological parameters on the accuracy of endoMRI. METHODS:Sixty-nine patients with pro...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000324098
更新日期:2011-01-01 00:00:00
abstract::Interstitial cystitis is a chronic benign disease of the bladder that causes bothersome and debilitating symptoms and mainly affects women. Since interstitial cystitis (IC) might result from a defective glycosaminoglycan layer of the bladder epithelium, we conducted a trial of hyaluronic acid (HA), used intravesically...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000283012
更新日期:1997-01-01 00:00:00
abstract::We performed four living related kidney transplantations from donors with double inferior vena cava (D-IVC), in which the left kidney was selected in two cases and the right in two cases. By dissecting the right internal iliac vein and isolating the right external iliac vein, the surgical procedure of the recipient si...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000077695
更新日期:2004-01-01 00:00:00
abstract::We report the case of a woman who presented with obstruction and urosepsis of her left kidney secondary to small cystine calculi. The calculi could not be seen on initial plain abdominal X-ray. However, following percutaneous nephrostogram the calculi became more radio-dense and visible on later X-rays. Experimental e...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000030375
更新日期:1999-01-01 00:00:00
abstract:BACKGROUND:To investigate the effect of hydrodynamic pressure mimicking vesicoureteral reflux on renal tubular epithelial cells in vitro, we constructed an intermittent pressure-loading (IPL) model of Madin-Darby canine kidney (MDCK) cells. MATERIALS AND METHODS:Three grades of pressure were loaded onto the MDCK cells...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000087170
更新日期:2005-01-01 00:00:00
abstract::Proteus syndrome is a rare hamartomatous disorder comprising a broad spectrum of congenital malformations and overgrowth of multiple tissues. Some rare urogenital malformations have been reported before. This case is unique for the presence of multiple genitourinary anomalies including retroperitoneal cystic mass, int...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000089744
更新日期:2006-01-01 00:00:00
abstract:INTRODUCTION AND OBJECTIVES:Meatal stenosis usually presents in adults with a history of urethral trauma or inflammation or as a complication after hypospadias repair. The objective of this study is to present the correction of meatal stenosis using a preputial island flap, created on the dorsal surface of the penis. ...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000102905
更新日期:2007-01-01 00:00:00
abstract:INTRODUCTION:We aimed at evaluating the incidence of lymphoceles, a common complication after radical retropubic prostatectomy (RRP), at a high volume centre, define risk factors and assess the clinical outcome. MATERIALS AND METHODS:454 patients receiving RRP and pelvic lymph node dissection were assessed for postope...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000381463
更新日期:2015-01-01 00:00:00
abstract:INTRODUCTION:The regulation proteins retinoblastoma protein (pRb) and p16 play an important role in the cell cycle as tumor suppressors. pRb is the main substrate for the function of cyclin-dependent kinases during the cell cycle in the transition from G(1) to S phase. In this study, the immunohistochemical expression ...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000320510
更新日期:2011-01-01 00:00:00
abstract:OBJECTIVES:To investigate whether congenital renal vein anomalies are involved in the etiology of hematuria by analyzing abdominal multidetector computed tomography (MDCT) results. METHODS:Six hundred and eighty patients undergoing MDCT for various abdominal pathologies in whom possible causes of hematuria were exclud...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000365664
更新日期:2015-01-01 00:00:00
abstract::Chromosomal anomalies may be a reason for male infertility. To find out whether this is true mitotic chromosome studies were performed on 41 males with azoospermia and 61 males with oligozoospermia. A constitutional chromosomal abnormality was diagnosed in 14 (34.1%) azoospermic patients and in 2 (3.3%) oligozoospermi...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000030280
更新日期:1998-10-01 00:00:00
abstract::Of 211 incontinent women the answer to each item of a questionnaire is correlated with the urodynamical data and the discriminative value for the type of incontinence is calculated. The relevant questions are discussed. ...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000281355
更新日期:1988-01-01 00:00:00
abstract::With this letter to the editor we present for the first time a study on CHEK2 expression in normal urothelium of healthy male smokers, former smokers and non-smokers. We could show a statistically significant downregulation of this DNA repair gene in current smokers compared to non-smokers, suggesting that smoking dow...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000446827
更新日期:2016-01-01 00:00:00
abstract::Urinoma as a presenting sign of carcinoma of the bladder, as occurred in this case, is rare. Aspiration of the cystic mass under sonography and chemistry of the fluid confirmed the diagnosis. The inferior extension of the urinoma on CT scan confirmed the gradual fading of Gerota's fascia into the retroperitoneum. Abdo...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000281044
更新日期:1985-01-01 00:00:00
abstract::From July 1992 to April 1994, 70 patients with prostatic cancer underwent laparoscopic pelvic lymph-node dissection (LPLD) before retropubic radical prostatectomy or afterloading therapy in our clinic. After an initial learning phase, the accuracy of LPLD was excellent, with only 3.0% residual nodes and no false-negat...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000282756
更新日期:1995-01-01 00:00:00
abstract:UNLABELLED:Polytraumatized patients often present with urological injuries. After hemodynamic stability is maintained urologists are consulted to evaluate diagnostic and therapeutic interventions. The following article describes how to handle the work-up of patients with injuries to specific urogenital organs: the impo...
journal_title:Urologia internationalis
pub_type: 杂志文章,评审
doi:10.1159/000074083
更新日期:2003-01-01 00:00:00
abstract::The purpose of this study is to report the safety and efficiency of laparoscopic varicocelectomy in 100 consecutive patients operated at a single teaching institution. There were three indications: (1) infertility associated with oligo-astheno-teratospermia (n = 52); (2) chronic dragging sensation of the left testicle...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000282986
更新日期:1997-01-01 00:00:00
abstract::Human factors is a definition that includes the science of understanding the properties of human capability, the application of this understanding to the design and development of systems and services, the art of ensuring their successful applications to a program. The field of human factors traces its origins to the ...
journal_title:Urologia internationalis
pub_type: 杂志文章,评审
doi:10.1159/000241662
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:There are relatively few studies that compare the use of transrectal ultrasound (TRUS) to magnetic resonance imaging (MRI) to estimate the prostate volume. In this study, we compared the prostate volumes measured with MRI and TRUS with a surgical specimen volume. PATIENTS AND METHODS:Seventy-three patient...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000100836
更新日期:2007-01-01 00:00:00
abstract:OBJECTIVE:Routine follow-up after cystectomy for bladder cancer detect patients with local recurrence late in the course of disease. We set out to determine the value of transrectal ultrasound (TRUS) as diagnostic tool to diagnose local failure. PATIENTS AND METHODS:Between 1986 and 2003, radical cystectomy for bladde...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000176018
更新日期:2009-01-01 00:00:00
abstract:OBJECTIVE:Increased pneumoperitoneum pressure during laparoscopic surgery can result in acute kidney injury. We aimed to clarify whether intraabdominal pressure tolerance is modified in various degrees of unilateral kidney hydronephrosis in rabbits. METHODS:A total 90 rabbits were randomly allocated to three groups (g...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000362845
更新日期:2015-01-01 00:00:00
abstract::The identification and diagnosis of thyroid metastases from renal adenocarcinoma are rare in living patients, though more frequent during autopsy. A case is reported in which the identification of thyroid metastases indicated a clear-cell renal carcinoma in a kidney treated 12 years earlier for emptying of multiple cy...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000281389
更新日期:1988-01-01 00:00:00
abstract::Plasma carcinoembryonic antigen (CEA) levels were performed preoperatively by radioimmunoassay in 124 patients with histologically proved bladder carcinoma. The level of CEA was used to determine its prognostic value in patients with bladder cancer. The correlation of CEA levels with the stage of the disease, histolog...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000280285
更新日期:1979-01-01 00:00:00
abstract::To help bolster penile tension mechanically, we have tried implantation of silicone penile prostheses varying in type. Our simple and apparently successful procedures for organic impotence with the implantation of intrapenile silicone prostheses may well deserve recommendation in view of spinal impairment therapeutica...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000279981
更新日期:1975-01-01 00:00:00
abstract:AIMS:To determine the optimal place to apply the local anesthetic agent and to investigate the efficacy of lidocaine-prilocaine cream on the perianal and intrarectal region during prostate biopsy. METHODS:The study included 80 patients. Patients were randomized into four groups: group 1 served as the control group and...
journal_title:Urologia internationalis
pub_type: 杂志文章,随机对照试验
doi:10.1159/000209354
更新日期:2009-01-01 00:00:00
abstract:INTRODUCTION:Many epidemiological and experimental studies report a strong role of chemical carcinogens in the etiology of bladder cancer. However, involvement of trace elements in the tumorigenesis of transitional cell carcinoma of the bladder has been poorly investigated. The aim of this study was to examine the rela...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000341976
更新日期:2012-01-01 00:00:00
abstract:AIMS:This study aimed to investigate the safety and efficacy of preoperative temporary inferior vena cava (IVC) filter placement and intraoperative application of a liver mobilization technique. MATERIALS AND METHODS:The experiment cohort of 42 cases and the control cohort of 36 cases of renal cell carcinoma involving...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000350521
更新日期:2013-01-01 00:00:00
abstract::We report a case of a 75-year-old female with pheochromocytoma of the bladder. Clinical evaluation included ultrasonography, intravenous pyelography, CT scan, I-MIBG scintiscan. A transurethral resection was performed for a exophytic tumor of 2 cm diameter. The histological result indicated the diagnosis of bladder ph...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000064868
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND/AIMS:Periurethral cysts are a rare entity that may be confused with urethral diverticula. The protocol for diagnosis and management of these lesions is still unclear. We present our experience with six patients presenting with periurethral cysts. METHODS:From 2001 to 2005 we evaluated six patients with a pa...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000098068
更新日期:2007-01-01 00:00:00
abstract::In 1 out of 56 patients, orchiectomized in the course of treatment for prostatic carcinoma, metastatic growth in the testis was found. This uncommon metastatic spread is a sign of advanced disease. ...
journal_title:Urologia internationalis
pub_type: 杂志文章
doi:10.1159/000281859
更新日期:1987-01-01 00:00:00