| Perugia ileal neobladder: functional results and complications. | |
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MedLine Citation:
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PMID: 23142825 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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PURPOSE: 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). METHODS: 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. RESULTS: 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. CONCLUSIONS: 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. |
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Authors:
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Massimo Porena; Luigi Mearini; Alessandro Zucchi; Michele Del Zingaro; Ettore Mearini; Antonella Giannantoni |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-11-13 |
Journal Detail:
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Title: World journal of urology Volume: - ISSN: 1433-8726 ISO Abbreviation: World J Urol Publication Date: 2012 Nov |
Date Detail:
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Created Date: 2012-11-12 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8307716 Medline TA: World J Urol Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Urology Department, University of Perugia, Sant'Andrea delle Fratte, 06100, Perugia, Italy. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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