Fasanella Daniela, Marchioni Michele, Domanico Luigi, Franzini Claudia, Inferrera Antonino, Schips Luigi, Greco Francesco
Urology Unit, Department of Medical, Oral and Biotechnological Sciences, G. d'Annunzio University of Chieti, SS Annunziata Hospital, 66100 Chieti, Italy.
Urology Unit, Centro Salute Uomo, Via Palma il Vecchio 4a, 24122 Bergamo, Italy.
Life (Basel). 2022 Aug 4;12(8):1193. doi: 10.3390/life12081193.
Orthotopic neobladder (ONB) reconstruction is a continent urinary diversion procedure increasingly used in patients with muscle-invasive bladder cancer following radical cystectomy (RC). It represents a valid alternative to the ileal duct in suitable patients who do not prefer a stoma and are motivated to undergo adequate training of the neobladder. Careful patient selection, taking into account the absolute and relative contraindications for ONB as well as an adequate recovery protocol after surgery are integral to the success of this procedure and the oncological and functional outcomes. The objective of this review is to summarize the current data on RC with ONB in terms of patient selection, preoperative preparation, surgical techniques and functional (continence and sexual activity) and oncological outcomes, with particular attention to the management of complications and the impact on quality of life (QoL).
原位新膀胱(ONB)重建术是一种可控性尿流改道术,在根治性膀胱切除术(RC)后越来越多地应用于肌层浸润性膀胱癌患者。对于不希望有造口且有动力接受新膀胱充分训练的合适患者,它是回肠导管的有效替代方案。仔细的患者选择,考虑到ONB的绝对和相对禁忌证以及术后适当的恢复方案,对于该手术的成功以及肿瘤学和功能结局至关重要。本综述的目的是总结目前关于RC联合ONB在患者选择、术前准备、手术技术以及功能(控尿和性功能)和肿瘤学结局方面的数据,特别关注并发症的管理及其对生活质量(QoL)的影响。