The Long-Term Follow-Up and Complications Associated with Urinary Diversion in the Cancer Survivor

被引:0
作者
Romo P.G.B. [1 ]
Stoffel J.T. [2 ]
机构
[1] Department of Urology, Clinical Fellow in Female Pelvic Medicine, Reconstructive Surgery, University of Michigan, Ann Arbor, 48109, MI
[2] Department of Urology, Division of Neurourology, Pelvic Floor Reconstruction, University of Michigan, Ann Arbor, 48109, MI
关键词
Long-term complications; Radical cystectomy; Renal insufficiency; Urinary diversion;
D O I
10.1007/s11884-016-0359-2
中图分类号
学科分类号
摘要
Over 60 % of patients can experience some type of long-term complication after radical cystectomy and urinary diversion (UD). However, assessment of late complications is challenging due to limited long-term available data for follow-up, different surgical techniques of UD, and selection bias towards diversion type. The aim of this article was to perform a systematic review and classify long-term complications from UD after radical cystectomy for bladder cancer. Renal insufficiency is the most commonly reported high grade adverse event, followed by ureteroenteric anastomotic strictures and bowel complications. Urinary infections are very common and challenging to assess given the presence of colonization and vague symptoms that can be associated to this diagnosis and pyelonephritis if presence of flank pain. Common complications by diversion type include stones, stomal stenosis, or parastomal hernia for urinary conduit and continent cutaneous urinary diversions, as well as urinary incontinence for orthotopic neobladder. Long-term complications are common after radical cystectomy and urinary diversion. Follow-up should be implemented for life to survey for complications. Improving access to these patients and communication with their local practitioners or local urologists when referred back to specialized urology clinic is fundamental to manage these long-term complications. © 2016, Springer Science+Business Media New York.
引用
收藏
页码:120 / 129
页数:9
相关论文
共 64 条
[1]  
Nielsen M.E., Mallin K., Weaver M.A., Et al., Association of hospital volume with conditional 90-days mortality after cystectomy: an analysis of the National Cancer Data Base, BJU Int, 114, pp. 46-55, (2014)
[2]  
Stenzl A., Cowan N.C., De Santis M., Et al., Update of the clinical guidelines of the European association of urology on muscle-invasive and metastatic bladder carcinoma, Actas Urol Esp, 34, pp. 51-62, (2010)
[3]  
Figueroa A.J., Stein J.P., Dickinson M., Et al., Radical cystectomy for elderly patients with bladder carcinoma: an updated experience with 404 patients, Cancer, 83, pp. 141-147, (1998)
[4]  
Hautmann R.E., Egghart G., Frohneberg D., Miller K., The ileal neobladder, J Urol, 139, pp. 39-42, (1988)
[5]  
Studer U.E., Ackermann D., Casanova G.A., Zingg E.J., Three years’ experience with an ileal low pressure bladder substitute, Br J Urol, 63, pp. 43-52, (1989)
[6]  
Hautmann R.E., Abol-Enein H., Lee C.T., Et al., Urinary diversion: how experts divert, Urology, 85, pp. 233-238, (2015)
[7]  
Rowland R.G., Mitchell M.E., Bihrle R., Et al., Indiana continent urinary reservoir, J Urol, 137, pp. 1136-1139, (1987)
[8]  
Lockhart J.L., Remodeled right colon: an alternative urinary reservoir, J Urol, 138, pp. 730-734, (1987)
[9]  
Bejany D.E., Politano V.A., Stapled and nonstapled tapered distal ileum for construction of a continent colonic urinary reservoir, J Urol, 140, pp. 491-494, (1988)
[10]  
Hautmann R.E., Abol-Enein H., Davidsson T., Et al., ICUD-EAU international consultation on bladder cancer 2012: urinary diversion, Eur Urol, 63, pp. 67-80, (2013)