Laparoscopic radical cystectomy and urinary diversion in Italian monocentric study: Results and complication of 58 cases with a median of 10 years of follow up

BACKGROUND: Radical cystectomy is the standard treatment for nonmetastatic bladder cancer (muscle-invasive and selective superficial bladder cancer). There are many types of urinary diversion after this procedure; the ileal conduit is the most and simplest one. AIM: To asses clinical, pathological profile, early complication, functional and oncological outcome after radical cystectomy and ileal conduit for muscle-invasive bladder cancer patients. METHOD: Between January 2013 and December 2016, there were 68 patients diagnosed with bladder cancer. From those patients, 24 (35.29%) patients had been performed radical cystectomy with ileal conduit type for urinary diversion (100%). Patients demographic, clinical and pathological profile, early postoperative complication, functional and oncological outcome were collected from the medical record. RESULT: Among the 24 patients who underwent radical cystectomy, 20 patients were male (83.3%) with the mean age was 57.3 y.o (33–77 y.o). Twelve patients (50%) showed pT4 and pT2 respectively. Based on pathological result 20 patient (83.34%) had the urothelial carcinoma, three patients (12.5%) had squamous cell carcinoma, and one patient (4.1%) had adenocarcinoma. Two patients (8.3%) got neoadjuvant chemotherapy, and nine patient (37.5%) of patients followed adjuvant chemotherapy after surgery. Wound dehiscence, fistula enterocutan, prolong ileus, leakage anastomosis and sepsis were kind of complication after surgery. One year's survival rate is 84%, mortality rate 20.8% and a recurrence rate of 20.8% in 4 years follow up. CONCLUSION: Radical cystectomy and ileal conduit type of urinary diversion still become the preferable procedure for nonmetastatic bladder cancer with good functional and oncological outcome.

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Treatment and outcomes of urethral recurrence after orthotopic neobladder replacement in patients with bladder cancer — practice in a single centre

Journal of International Medical Research ◽

10.1177/0300060518782015 ◽

2018 ◽

Vol 46 (9) ◽

pp. 3928-3937 ◽

Cited By ~ 1

Author(s):

Xiaozhou Zhou ◽

Huixiang Ji ◽

Heng Zhang ◽

Tailin Xiong ◽

Jinhong Pan ◽

...

Keyword(s):

Radical Cystectomy ◽

Urinary Diversion ◽

Clinical Information ◽

Tumour Resection ◽

En Bloc ◽

Cancer Specific Survival ◽

Time To Recurrence ◽

Orthotopic Urinary Diversion ◽

Urethral Recurrence

Objectives To report on the treatment of urethral recurrence after orthotopic urinary diversion at our institution. Methods We retrospectively reviewed clinical information of urethral recurrence in patients who underwent radical cystectomy and orthotopic urinary diversion between January 1998 and January 2013. Results Of 341 patients, 282 presented for follow-up (median follow-up: 56 months; range: 1–174 months). Eight patients developed local recurrence of urothelial cancer after radical cystectomy. The rate of urethral recurrence (1.4%) in female patients who underwent orthotopic urinary diversion was lower than in male patients (3.3%). The median (range) time to recurrence was 33 (6–120) months after radical cystectomy and orthotopic urinary diversion. Recurrences were treated by transurethral resection of tumour, urethrectomy, neobladder resection, revision of urinary diversion, adjuvant chemotherapy, or radiation therapy, based on individual circumstances. Survival analysis showed that 5-year cancer-specific survival was significantly higher in patients with urethral recurrence alone (83.3%), compared with patients with other recurrences, including pelvic/abdomen recurrence and distant metastasis (26.8%). Conclusions En bloc urethrectomy and revision of urinary diversion remain the principle surgical choices. Selection of transurethral tumour resection was based on tumour stage and was used in carefully chosen patients. Cancer-specific survival might depend on multidisciplinary therapy.

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