Introduction: Peri operative morbidity (POM) of RC is subject of discussion recently. This review focuses on the review of contemporary literature on peri operative morbidity of RC and our clinical
Material and Methods; We report the analysis of our hospital data of 238 Radical Cystectomy performed in 11 yr period and our latest clinical pathway of RC .
Results: We report our experience of 238 RC performedover 11 years. Age range was 50-81year with 218 males and 20 females. Radical cystectomies were performed by standard Intra peritoneal method
(IP) in 159 patients and our extra peritoneal method (EP) in 69 patients. Urinary diversion was ileal conduit in 168 and neo bladder in 71 patients. For analysis patients grouped in 2 i.e primary
RC (GrA)N=164 patients and Neo adjuvant therapy (Gr B) n=74 patients. In majority of patients blood loss was 500 -1500ccs and was identical in both groups. Operating time was 4-8hrs and hospital
stay was 15-60 days with median of 18 days in both groups. Early Mortality was seen in 3/164 GrA and in 1/74 group B patients. At least 1 complication occurred in 27/164 in A group and in 8/74 B
group. Other complications like urine leak occurred 11 of Gr A and 6 of Gr B while bowel problems including leak/obstruction and ileus were seen 13 of GrA and 7 of Gr B patients. Minor
complications were identical in both groups.
Discussion: RC because of complex nature of surgery has inherent morbidity & mortality. Neo adjuvant therapy (chemo therapy or RT or combination) has been labeled as the risk factors for the
morbidity of RC. Our data although retrospective, shows no additional risk for morbidity of RC. Further most series are retrospective analyses and lacks standard complication reporting criterion
limiting the comparison of out comes of the surgical techniques in them. We believe neo adjuvant therapy can yield good results if balanced critically and appropriate corrective measures are
Conclusions: Open RC is standard of care for Bladder cancer. Modern refinements in surgical techniques and multi disciplinary approach have led to reduction in perioperative mortality but POM is
still challenge. There is need for standard guide lines for reporting out comes and morbidity of surgical techniques.