To evaluate the operation of laparoscopic radical cystectomy with W-shaped ileal neobladder in the elderly.

34 bladder cancer patients underwent robot-assisted/conventional laparoscopic radical cystectomy with W-shaped ileal neobladder in the First Affiliated Hospital of Soochow University from December 2018 to May 2023 in total were admited. They were classified as elderly group, (72.3±1.9) years old of 12 patients and non-elderly group, (59.9±6.1) years old of 22 patients. The preoperative data, perioperative indicators, incidence of within 90-day complications, urinary control and oncologic prognosis were assessed.

Surgeries were successful. There were no significant differences between the two groups in operation duration, surgical estimated bleeding, postoperative exsufflation/eating semi-fluid/drainage time, postoperative hospital stay, tumor pathological stage and rate of pelvic lymph node metastasis (P>0.05). The incidence of within 90-day complications in elderly patients and non-elderly patients were 58.3% vs 50.0% (P>0.05 ). Both of complications were mild. There were no significant differences in the prognosis of neobladder function between the two groups (P>0.05) such as daytime/nighttime continence rate and urine volume. Follow-up of the elderly group for 7-20 months revealed no tumor recurrence.

Elderly alone is not a contraindication for orthotopic neobladder. For appropriate elderly patients with bladder cancer, laparoscopic radical cystectomy with W-shaped ileal neobladder can be considered with perioperative care and follow-up. The surgical form is feasible in the elderly with mild perioperative complications, satisfying neobladder function and oncological outcomes.