Perugia ileal neobladder: functional results and complications

被引:13
作者
Porena, Massimo [1 ]
Mearini, Luigi [1 ]
Zucchi, Alessandro [1 ]
Del Zingaro, Michele [1 ]
Mearini, Ettore [1 ]
Giannantoni, Antonella [1 ]
机构
[1] Univ Perugia, Dept Urol, I-06100 Perugia, Italy
关键词
Bladder cancer; Ileal neobladder; Follow-up; Clavien-Dindo; Continence; Functional results; VOIDING DYSFUNCTION; BLADDER-CANCER; URINARY-TRACT; T-POUCH; CYSTECTOMY; EXPERIENCE; OUTCOMES;
D O I
10.1007/s00345-012-0985-z
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
To evaluate the long-term functional results and complications of an orthotopic ileal neobladder, defined as perugia ileal neobladder (PIN), in a group of patients with bladder cancer who underwent radical cystectomy (RC). Between 1993 and 2009, 237 consecutive patients who underwent RC for non-metastatic bladder cancer and orthotopic ileal neobladder reconstruction were enrolled. The neobladder was created using a modified Camey-II technique and consisted of a detubularized ileal loop of 45 cm using a vertical "Y" shape. Complications (< 90 days) were reviewed and staged according to Clavien-Dindo classification and evaluated at long-term follow-up. Standard monitoring for cancer recurrence (computerized tomography, bone scan), cystourethrography, urodynamics and frequency/volume charts were performed during follow-up. The median follow-up was 64 months, and the 5-year overall survival rate was 64 %. Early complications were mostly grade I and II; grade III and IV complications were observed in 27 patients. Perioperative mortality rate was 1.6 %. The most frequent late complications were neobladder-ureteral reflux, urolithiasis and urethral anastomotic stricture. Daytime and nighttime urinary continence were 93.5 and 83.9 %, respectively. All patients were able to completely empty neobladders. Twenty patients were followed up for at least 10 years and presented satisfactory functional results. Surgical morbidity of RC and orthotopic neobladder was significant; however, the rate of grade III-IV complications was low. The long-term functional results of the PIN were interesting, confirming that appropriate patients' selection, adequate surgical technique, accurate patients' counseling and follow-up are essential.
引用
收藏
页码:747 / 752
页数:6
相关论文
共 29 条
  • [11] Long-term results of orthotopic neobladder reconstruction after radical cystectomy
    Kulkarni, JN
    Pramesh, CS
    Rathi, S
    Pantvaidya, GH
    [J]. BJU INTERNATIONAL, 2003, 91 (06) : 485 - 488
  • [12] Renal and functional outcomes following cystectomy and neobladder reconstruction
    Lantz, Andrea G.
    Saltel, Eric
    Cagiannos, Ilias
    [J]. CUAJ-CANADIAN UROLOGICAL ASSOCIATION JOURNAL, 2010, 4 (05): : 328 - 331
  • [13] Are sexual activity and satisfaction affected by pelvic floor disorders? Analysis of a community-based survey
    Lukacz, Emily S.
    Whitcomb, Emily L.
    Lawrence, Jean M.
    Nager, Charles W.
    Contreras, Richard
    Luber, Karl M.
    [J]. AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2007, 197 (01) : 88.e1 - 88.e6
  • [14] Long-term voiding pattern of patients with ileal orthotopic bladder substitutes
    Madersbacher, S
    Möhrle, K
    Burkhard, F
    Studer, UE
    [J]. JOURNAL OF UROLOGY, 2002, 167 (05) : 2052 - 2057
  • [15] Mearini E, 2000, EUR UROL SUPPL, V37, P564
  • [16] Voiding dysfunction in ileal neobladder
    Mikuma, N
    Hirose, T
    Yokoo, A
    Tsukamoto, T
    [J]. JOURNAL OF UROLOGY, 1997, 158 (04) : 1365 - 1368
  • [17] Functional Results Following Vescica Ileale Padovana (VIP) Neobladder: Midterm Follow-up Analysis with Validated Questionnaires
    Novara, Giacomo
    Ficarra, Vincenzo
    Minja, Anila
    De Marco, Vincenzo
    Artibani, Walter
    [J]. EUROPEAN UROLOGY, 2010, 57 (06) : 1045 - 1051
  • [18] TOXICITY AND RESPONSE CRITERIA OF THE EASTERN-COOPERATIVE-ONCOLOGY-GROUP
    OKEN, MM
    CREECH, RH
    TORMEY, DC
    HORTON, J
    DAVIS, TE
    MCFADDEN, ET
    CARBONE, PP
    [J]. AMERICAN JOURNAL OF CLINICAL ONCOLOGY-CANCER CLINICAL TRIALS, 1982, 5 (06): : 649 - 655
  • [19] Functional lower urinary tract voiding outcomes after cystectomy and orthotopic neobladder
    Parekh, DJ
    Gilbert, WB
    Smith, JA
    [J]. JOURNAL OF UROLOGY, 2000, 163 (01) : 56 - 58
  • [20] Ureterointestinal anastomosis in orthotopic neobladders
    Porena, M
    Mearini, L
    Zucchi, A
    Mearini, E
    [J]. UROLOGIA INTERNATIONALIS, 2000, 64 (04) : 181 - 184