Talat Z, Onal B, Cetinel B, Demirdag C, Citgez S, Dogan C
Department of Urology, Istanbul University-Cerrahpasa, Cerrahpasa Medical Faculty, Fatih, 34098, Istanbul, Turkey.
BMC Urol. 2018 Oct 26;18(1):94. doi: 10.1186/s12894-018-0406-8.
We describe a detailed novel step-by-step approach for creation of an ileal neobladder and compare the outcomes with standart neobladder.
Between August 2009 and January 2016, 36 consecutive patients with bladder cancer underwent radical cystectomy and orthotopic urinary diversion with an ileal neobladder. A novel technique of ileal neobladder construction, called the Anatolian neobladder, was designed by a single surgeon (ZT). Demographics and clinical data were collected. Perioperative, oncologic, and functional outcomes were reported. Complications were graded as early or late. These outcomes were compared with patients who underwent standard neobladder during this period in our center.
The operation was technically successful in all cases. Early postoperative complications occurred in 33.3% of the patients. Daytime continence was achieved successfully in 83.3% of the patients. No patient had severe metabolic acidosis. Six patients (16.6%) died during follow-up, five due to metastatic bladder cancer and one due to a cardiac problem. There was no any statistically significant difference between novel technique and standard neobladder for oncological and functional outcomes.
The Anatolian ileal neobladder is as feasible and safe as standard neobladder technique for urinary diversion in patients with bladder cancer undergoing radical cystectomy.
我们描述了一种详细的、新颖的逐步构建回肠新膀胱的方法,并将其结果与标准新膀胱进行比较。
2009年8月至2016年1月期间,36例连续性膀胱癌患者接受了根治性膀胱切除术及回肠新膀胱原位尿流改道术。一种名为安纳托利亚新膀胱的回肠新膀胱构建新技术由一名外科医生(ZT)设计。收集了人口统计学和临床数据。报告了围手术期、肿瘤学和功能学结果。并发症分为早期或晚期。将这些结果与同期在本中心接受标准新膀胱手术的患者进行比较。
所有病例手术技术均成功。33.3%的患者发生早期术后并发症。83.3%的患者成功实现白天控尿。无患者发生严重代谢性酸中毒。6例患者(16.6%)在随访期间死亡,5例死于转移性膀胱癌,1例死于心脏问题。新技术与标准新膀胱在肿瘤学和功能学结果方面无任何统计学显著差异。
对于接受根治性膀胱切除术的膀胱癌患者,安纳托利亚回肠新膀胱在尿流改道方面与标准新膀胱技术一样可行且安全。