Siddiqui Khurram M, Izawa Jonathan I
Departments of Surgery, Oncology and Pathology, Divisions of Urology and Surgical Oncology, Schulich School of Medicine & Dentistry, London Health Sciences Centre-Victoria Hospital, Western University, 800 Commissioners Road East, Room E2-649, London, ON, N6A 5W9, Canada.
World J Urol. 2016 Jan;34(1):19-24. doi: 10.1007/s00345-015-1706-1. Epub 2015 Oct 16.
Ileal conduit (IC) is the most frequent urinary diversion (UD) performed after radical cystectomy (RC). We reviewed the literature to investigate the factors influencing the choice of this diversion and its complications.
A literature search (PubMed) was performed for all English language publications on UDs performed for treatment of bladder cancer from 1950 to 2015. The literature review was focused on studies reporting outcome of IC and its comparison with other types of UDs.
IC is the most common UD performed in elderly patients undergoing RC for bladder cancer. Long-term studies looking at the change in renal function after UD report a universal decline in the glomerular filtration rate; however, this decline in renal function is the least for IC. There is a significant morbidity of RC (20-56 %), which can be attributed to patient factors, surgical technique and hospital volume. Modern concepts of bowel preparation, postoperative nutrition, early enteral feeding and involvement of stoma therapists have helped improve the outcomes. The quality of life is preserved, and in many including elderly, it may be improved with IC UD.
IC is the most commonly performed UD following radical cystectomy. It is associated with acceptable morbidity and has the lowest reoperation rates as compared to continent diversion. It is also the procedure of choice for most patients' elderly patients as well as patients with limited dexterity, poor motivation, anatomical restrictions and poor renal function. Studies measuring HRQOL report excellent patient acceptability, especially in the elderly population.
回肠代膀胱术（IC）是根治性膀胱切除术（RC）后最常用的尿流改道术（UD）。我们回顾文献以研究影响该尿流改道术选择及其并发症的因素。
在PubMed上检索1950年至2015年期间所有关于因膀胱癌行尿流改道术的英文出版物。文献综述聚焦于报告回肠代膀胱术结果及其与其他类型尿流改道术比较的研究。
回肠代膀胱术是老年膀胱癌患者行根治性膀胱切除术后最常用的尿流改道术。观察尿流改道术后肾功能变化的长期研究报告肾小球滤过率普遍下降；然而，回肠代膀胱术导致的肾功能下降最少。根治性膀胱切除术有显著的并发症发生率（20% - 56%），这可归因于患者因素、手术技术和医院规模。现代的肠道准备、术后营养、早期肠内喂养及造口治疗师参与等理念有助于改善结果。生活质量得以保留，在许多患者包括老年人中，回肠代膀胱术尿流改道可能会改善生活质量。
回肠代膀胱术是根治性膀胱切除术后最常用的尿流改道术。与可控性尿流改道相比，其并发症发生率可接受且再次手术率最低。它也是大多数老年患者以及灵活性受限、积极性差、存在解剖学限制和肾功能差的患者的首选术式。测量健康相关生活质量的研究报告患者接受度良好，尤其是在老年人群中。
