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.

Laparoscopic Radical Cystectomy with Extracorporeal Ileal Conduit Urinary Diversion for Treatment of Chinese Bladder Cancer Patients

2007 ◽  
Vol 79 (3) ◽  
pp. 204-209 ◽  
Author(s):  
Zhen-Li Gao ◽  
Jie Fan ◽  
Jun-Jie Zhao ◽  
Shu-Jie Xia ◽  
Lei Shi ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Cancer Patients ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Ileal Conduit

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 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 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.

scholarly journals Comparison of survival in elderly patients treated with uretero-cutaneostomy or ileal conduit after radical cystectomy

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shang Huang ◽  
Hanzhong Chen ◽  
Teng Li ◽  
Xiaoyong Pu ◽  
Jiumin Liu ◽  
...  
Keyword(s):  
Risk Factors ◽  
Overall Survival ◽  
Bladder Cancer ◽  
Cancer Patients ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Tumor Stage ◽  
Node Density ◽  
Cancer Specific Survival

Abstract Background In bladder cancer patients with age ≥ 80 years old, there have been controversies in performing uretero-cutaneostomy or ileal conduit as urinary diversion after radical cystectomy. Limited study evaluated overall survival (OS) and cancer-specific survival (CSS) between the two urinary diversions in elderly patients. This study is to compare OS and CSS between uretero-cutaneostomy and ileal conduit after radical cystectomy in bladder cancer patients with age ≥ 80 years old. Patients and methods Data were extracted from the Surveillance, Epidemiology, and End Results (SEER) database. Bladder cancer patients diagnosed between 2004 and 2016 with age ≥ 80 years old who underwent radical cystectomy with either UC or IC were selected. After propensity score matching, Cox regression and Kaplan-Meier analysis were used to analyze the survival. We calculated statistical power for survival. Results Of 1394 patients who met the inclusion criteria, 1093 underwent ileal conduit and 301 underwent uretero-cutaneostomy. After propensity score matching, 285 patients were included in each group. Multivariable Cox analysis showed urinary diversion was not a risk factor of OS and CSS (HR 1.044, [95% CI 0.867–1.257] and 1.012 [0.748–1.368], respectively). Both OS and CSS were not significantly different, with median survival of ileal conduit and uretero-cutaneostomy were 19 [16–24] months and 19 [15–26] months respectively. Additionally, We found OS had the following risk factors: tumor stage (distant vs regional vs localized, 5.332 [3.610–7.875] vs 1.730 [1.375–2.176] vs 1), node density (>0.2 vs ≤0.2 vs none, 1.410 [1.047–1.898] vs 0.941 [0.658–1.344] vs 1) and age (1.067 [1.032–1.103] for each year). While CSS had the following risk factors: tumor stage (distant vs regional vs localized, 4.035 [2.046–7.959] vs 2.476 [1.651–3.713] vs 1), node density (>0.2 vs ≤0.2 vs none, 2.501 [1.645–3.804] vs 1.062 [0.590–1.914] vs 1) and tumor size (greater than 3 cm vs less than 3 cm, 1.596 [1.057–2.412] vs 1). Our analysis obtained 0.707 power for overall survival. Conclusion Urinary diversion by uretero-cutaneostomy or by ileal conduit was not associated with overall and cancer-specific survival. It is reasonable to consider uretero-cutaneostomy as a regular procedure of urinary diversion in elderly bladder cancer patients after radical cystectomy to avoid associate complications.

A modified ileal conduit technique in patients undergoing radical cystectomy: Single-centre experience

2021 ◽  
pp. 205141582110414
Author(s):  
Francesco Chiancone ◽  
Francesco Persico ◽  
Marco Fabiano ◽  
Maurizio Fedelini ◽  
Clemente Meccariello ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Postoperative Complications ◽  
Blood Loss ◽  
Radical Cystectomy ◽  
Ileal Conduit ◽  
Intraoperative Complications ◽  
Perioperative Outcomes ◽  
Multivariate Logistic Regression Model ◽  
Increased Risk

Objective: We aimed to evaluate perioperative outcomes and complications of a modified technique of ileal conduit diversion. Methods: Forty-seven cases of radical cystectomy with modified ileal conduit diversion were performed at our institution from January 2015 to January 2020. After radical cystectomy, a segment of ileum was used to pack the conduit and was placed below the digestive anastomosis. Then, the mesentery window of the ileo-ileal anastomosis was sutured. The ureters were anastomosed on their native side on single loop ureteral stents. All procedures were performed by a single surgical team. Intra- and postoperative complications were classified and reported according to the Satava and Clavien–Dindo grading systems. Results: The mean age of population was 66.40±10.14 years, and 76.6% were male. Concomitant diabetes was found in 31.9% of patients. About three quarters of patients had T2G3 bladder cancer. Mean blood loss was 449.36±246.50 ml, and hospitalization was 10.32±5 days. With a mean follow-up of 17.36±12.63 months, the recurrence rate was 17%, and 14.9% of patients died of bladder cancer. Out of the 47 patients, three (4.3%) experienced intraoperative complications, while 15 (31.9%) had postoperative complications. Of these, only three patients experienced Clavien–Dindo complications ⩾grade 3. Multivariate logistic regression model showed that diabetes ( p=0.023) and higher blood loss ( p=0.010) were significantly associated with an increased risk of postoperative complications. We reported one case of ureterointestinal anastomosis stenosis on the left side and none on the right side. Despite our results being promising, larger randomized trials with longer follow-up are needed to explore further the feasibility of this technique on a larger scale. Conclusion: We describe a safe and simple surgical technique with a similar postoperative complications rate and a lower incidence of ureteroileal anastomosis stenosis compared to the standard technique. Level of evidence 4.

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