scholarly journals Outcome of Radical Cystectomy With Urinary Diversion at Nicrh, Bangladesh

2020 ◽  
Vol 21 (2) ◽  
pp. 62-65
Author(s):  
Md Shawkat Alam ◽  
Howlader Fazlul Karim ◽  
Md Monowarul Islam ◽  
Md Siddiqur Rahman ◽  
SK Amirul Islam ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Disease Free Survival ◽  
Oncological Outcome ◽  
Distant Recurrence ◽  
Early Recurrence ◽  
Ileal Neobladder ◽  
Muscle Invasive ◽  
Si Joint

Introduction: Radical Cystectomy (RC) is an effective surgical procedure for muscle invasive bladder cancer ( MIBC). 5 years disease free survival after RCs are PT2 - 81%, PT3a – 68%, PT3b – 47%, PT4a – 44% respectively, Stein et al, 2001[1]. In this study early surgical & oncological outcome have been assessed. Patients & methods: A total of 24(N) patients underwent radical cystectomy with urinary diversion between December 2013 to June 2016. Age ranges from 41-69 years. Indications were T2HG for twenty cases and T1HG for four cases. Among the T1 tumours, one had early recurrence, one had numerous tumours and two had multiple tumours with concomitant CIS. Urinary diversion methods were: Orthotopic Ileal neobladder-1, Ileal conduit-20, Cuteneous Ureterostomy -3 (2 due to unhealthy mesentry with gut, 1 single kidney with poor general condition), For uretero-Ileal anaestomosis we used Bricker method in all cases. Result: Mean OR time was 3:45 hours, blood loss average 350 ml, hospital stay after operation 9 days, enlarged pelvic lymph nodes were found in two cases. In follow up we found,stomal stenosis of cutaneous ureterostomy in 1 out of 3 cases, Ileal conduit prolapse with para-stomal hernia in 1 out of 20 cases, stenosis at uretero-Ileal anastomosis in 1 pt. .Distant recurrence occurred in two cases, one in Lt. Supraclavicular LN and another in sacrum near SI joint. No local recurrence was found in any case. Conclusion: Our experience on RC and all the three types of UD are safe and effective for patient and encouraging for us. Bangladesh Journal of Urology, Vol. 21, No. 2, July 2018 p.62-65

scholarly journals Pathological Profile, Early Complications, Functional and Oncological Outcome after Radical Cystectomy - Ileal Conduit for Bladder Cancer Patients in Sanglah General Hospital between January 2013 and December 2016

2018 ◽  
Vol 6 (9) ◽  
pp. 1647-1651 ◽  
Author(s):  
Yudiana Wayan ◽  
Pratiwi Dinar Ayu ◽  
Oka A. A. Gde ◽  
Niryana Wayan ◽  
I Putu Eka Widyadharma
Keyword(s):  
Bladder Cancer ◽  
Cancer Patients ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Wound Dehiscence ◽  
Oncological Outcome ◽  
Pathological Result ◽  
Muscle Invasive

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.

scholarly journals Morbidity and Quality of Life in Bladder Cancer Patients following Cystectomy and Urinary Diversion: A Single-Institution Comparison of Ileal Conduit versus Orthotopic Neobladder

ISRN Urology ◽  
2012 ◽  
Vol 2012 ◽  
pp. 1-8 ◽  
Author(s):  
Barbara Erber ◽  
Mark Schrader ◽  
Kurt Miller ◽  
Martin Schostak ◽  
Daniel Baumunk ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Oncological Outcome ◽  
University Hospital ◽  
Ileal Neobladder ◽  
Eortc Qlq

Objective. To evaluate and compare noncontinent and continent urinary diversion after radical cystectomy in patients with bladder cancer. Methods. A total of 301 patients submitted to radical cystectomy at the Charité-University Hospital Berlin from 1993 to 2007 including 146 with an ileal conduit and 115 with an ileal neobladder. Clinical and pathological data as well as oncological outcome were retrospectively analyzed and compared. Quality of life was analyzed using the EORTC QLQ-C30 and BLM30 questionnaires. Results. 69.1% and 69.6% of all patients who received an ileal conduit and ileal neobladder, respectively, developed early complications. The two groups differed significantly concerning the occurrence of postoperative ileus (P=0.02) favoring patients who received an ileal conduit but not with regard to any other early-onset complication evaluated. Patients with ileal neobladder had a significantly better global health status and quality of life (P=0.02), better physical functioning (P=0.02), but also a higher rate of diarrhoea (P=0.004). Conclusion. Cystectomy with any type of diversion remains a complication-prone surgery. Even if the patient groups are not homogeneous in all respects, there are many arguments in favor of the ileal neobladder as the urinary diversion of choice.

scholarly journals Comparison of a Significant Decline in the Glomerular Filtration Rate between Ileal Conduit and Ileal Neobladder Urinary Diversions after Radical Cystectomy: A Propensity Score-Matched Analysis

2020 ◽  
Vol 9 (7) ◽  
pp. 2236 ◽  
Author(s):  
Jihion Yu ◽  
Bumsik Hong ◽  
Jun-Young Park ◽  
Yongsoo Lee ◽  
Jai-Hyun Hwang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Filtration Rate ◽  
Ileal Conduit ◽  
Significant Decline ◽  
Ileal Neobladder ◽  
Renal Function Impairment ◽  
Function Impairment ◽  
Gfr Decline

Urinary diversion after radical cystectomy is associated with a risk of renal function impairment. A significant decline in the glomerular filtration rate (GFR) (i.e., a ≥30% decline in baseline GFR after 12 months) is associated with long-term renal function impairment. We compared the significant GFR decline between ileal conduit and ileal neobladder urinary diversions 12 months after radical cystectomy. We retrospectively included radical cystectomy patients. Propensity score-matched analysis was performed. The primary outcome was the incidence of a significant GFR decline in ileal conduit urinary diversion (ileal conduit group) and ileal neobladder urinary diversion (ileal neobladder group) 12 months after radical cystectomy. The secondary outcomes were the change of GFR and the incidence of end-stage renal disease (ESRD) in the two groups. After propensity score matching, the ileal conduit and neobladder groups had 117 patients each. The incidence of a significant GFR decline was not significantly different between ileal conduit and ileal neobladder groups (12.0% vs. 13.7%, p = 0.845). The change of GFR and ESRD incidence were not significantly different between the two groups (−8.4% vs. −9.7%, p = 0.480; 4.3% vs. 5.1%, p > 0.999, respectively). These results can provide important information on appropriate selection of the urinary diversion type in radical cystectomy.

scholarly journals Quality of Life and Renal Functional Status In Patients With Cutaneous Ureterostomy and Ileal Conduit Urinary Diversion after Radical Cystectomy

2020 ◽  
Vol 23 (2) ◽  
pp. 142-150
Author(s):  
Subrata Deb ◽  
Md Golam Mowla Chowdhury ◽  
Mohammad Shafiqur Rahman ◽  
Mohammad Salahuddin Faruque ◽  
Ashraful Islam ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Function ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Group A ◽  
Muscle Invasive ◽  
Group B ◽  
Cutaneous Ureterostomy

Introduction: Radical cystoprostetectomy in male patients and anterior pelvic exenteration in female patients coupled with en-block pelvic lymphadenectomy and urinary reconstruction or diversion remains the gold standard surgical approach to muscle invasive bladder cancer in the absence of metastatic disease. In Bangladesh, commonly performed urinary diversions are Cutaneous ureterostomy and Ileal conduit. Types of urinary diversion have a great impact on different aspects of quality of life (QoL) as well as post -operative renal function. Aims and Objectives: This study was designed to compare the Quality of Life and Renal Function in between Cutaneous ureterostomy and Ileal conduit urinary diversion after radical cystectomy. Methodology: This was a hospital based Quasi Experimental study in which patients were selected by purposive sampling and, conducted from July, 2017 to September, 2018 in the department of Urology Bangabandhu Sheikh Mujib Medical University. This study was performed among the patients with muscle invasive bladder cancer treated by radical cystectomy with cutaneous ureterostomy or Ileal conduit fulfilling the exclusion and inclusion criteria. Total 34 patients were taken for the study, among them 17 for cutaneous ureterostomy and, 17 for Ileal Conduit Group. Quality of Life was assessed through EORTC-QLQ-C30 questionnaire both pre and post operatively (3 months after operation). Renal function was assessed before and 1st POD, 7thPOD, one month and three months after operation by measuring eGFR. Result: Mean age of the patients was 59.00 ± 8.60 years and 53.35 ± 8.43years in group- A (Cutaneous ureterostomy) and group-B (Ileal conduit) respectively. Three months after operation, overall QoL in all scales were improved in both group but, more improvements were noted in group-B than group-A which were statistically significant (p<0.05). The mean pre-operative eGFR was significantly lower in group-A than group-B (p<0.001). Three months after operation, statistically significant differences in eGFR, were observed within, and in between two groups (p<0.05). Percentage of eGFR changed (renal function deterioration) were significantly more in group-A than group-B (p=0.001). Conclusion: Quality of life, after radical cystectomy with ileal conduit is better than cutaneous ureterostomy and, post- operative renal function deterioration significantly less in ileal conduit group than cutaneous ureterostomy group. So, ileal conduit is an appropriate option of urinary diversion for the patient those who permit prolong operative procedure. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.142-150

scholarly journals Three-port approach vs standard laparoscopic radical cystectomy with an ileal conduit: a single-centre retrospective study

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhouting Tuo ◽  
Ying Zhang ◽  
Jinyou Wang ◽  
Huan Zhou ◽  
Youlu Lu ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Operative Time ◽  
Ileal Conduit ◽  
Oncological Outcome ◽  
Perioperative Outcomes ◽  
Post Surgery ◽  
Estimated Blood Loss ◽  
Muscle Invasive

Abstract Background This study aimed to evaluate the effect of the three-port approach and conventional five-port laparoscopic radical cystectomy (LRC) with an ileal conduit. Methods Eighty-four patients, who were diagnosed with high-risk non-muscle-invasive and muscle-invasive bladder carcinoma and underwent LRC with an ileal conduit between January 2018 and April 2020, were retrospectively evaluated. Thirty and fifty-four patients respectively underwent the three-port approach and five-port LRC. Clinical characteristics, pathological data, perioperative outcomes, and follow-up data were analysed. Results There were no differences in perioperatively surgical outcome, including pathology type, prostate adenocarcinoma incidence, tumour staging, and postoperative creatinine levels between the two groups. The operative time (271.3 ± 24.03 vs. 279.57 ± 48.47 min, P = 0.299), estimated blood loss (65 vs. 90 mL, P = 0.352), time to passage of flatus (8 vs. 10 days, P = 0.084), and duration of hospitalisation post-surgery (11 vs. 12 days, P = 0.922) were no clear difference between both groups. Compared with the five-port group, the three-port LRC group was related to lower inpatient costs (12 453 vs. 14 134 $, P = 0.021). Our follow-up results indicated that the rate of postoperative complications, 90-day mortality, and the oncological outcome did not show meaningful differences between these two groups. Conclusions Three-port LRC with an ileal conduit is technically safe and feasible for the treatment of bladder cancer. On comparing the three-port LRC with the five-port LRC, our technique does not increase the rate of short-term and long-term complications and tumour recurrence, but the treatment costs of the former were reduced.

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