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Supra-ampullar cystectomy and ileal neobladder.

Abstract：

OBJECTIVE:This article describes both the open and laparoscopic operative techniques of supra-ampullar cystectomy (SAC). METHODS:Both open (photographs and drawings) and laparoscopic (attached DVD) SAC are explained step by step. RESULTS:Between May 1984 and December 2005, 31 patients with bladder tumour underwent SAC with ileal orthotopic neobladder (2 Camey I, 26 Camey II, and 3 Y). Three patients underwent laparoscopy. Preoperatively, 26 patients had superficial high-risk transitional cell carcinoma (TCC). Median follow-up was 95.0 mo (range: 5-260 mo). The 10-yr cause-specific survival rate was 76.7%. Two patients had local recurrence. Potency was preserved in 28 patients (90.3%); 15 patients (48.3%) also maintained antegrade ejaculation, allowing procreation in 3 cases. In one patient the Camey I neobladder was converted into an ileal conduit (high postvoid residual, recurrent pyelonephritis). None of the remaining patients had daytime incontinence, eight had nightime urinary incontinence, and six performed intermittent self-catheterisation. CONCLUSION:SAC with detubularised ileal orthotopic neobladder allows preservation of sexual function and maintenance of urinary continence in most patients, without compromising oncologic outcome. The key element is the very strict and careful preoperative selection of the patients.

journal_name

Eur Urol

journal_title

European urology

authors

Terrone C,Porpiglia F,Cracco C,Tarabuzzi R,Cossu M,Renard J,Scarpa RM,Rocca Rossetti S

doi

10.1016/j.eururo.2006.07.049

subject

Has Abstract

pub_date

2006-12-01 00:00:00

pages

1223-33

issue

6

eissn

0302-2838

issn

1873-7560

pii

S0302-2838(06)00888-8

journal_volume

50

pub_type

杂志文章

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