Document Detail

Perugia ileal neobladder: functional results and complications.
MedLine Citation:
PMID:  23142825     Owner:  NLM     Status:  Publisher    
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.
Massimo Porena; Luigi Mearini; Alessandro Zucchi; Michele Del Zingaro; Ettore Mearini; Antonella Giannantoni
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-13
Journal Detail:
Title:  World journal of urology     Volume:  -     ISSN:  1433-8726     ISO Abbreviation:  World J Urol     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-12     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8307716     Medline TA:  World J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Urology Department, University of Perugia, Sant'Andrea delle Fratte, 06100, Perugia, Italy.
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