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The Z-shaped ileal neobladder after radical cystectomy: an 18 years experience with 329 patients.

Abstract：

UNLABELLED:Study Type - Therapy (case series). LEVEL OF EVIDENCE:4. OBJECTIVE:To evaluate the results in terms of functional results and morbidity of Z-shaped ileal neobladder performed in a single center. PATIENTS AND METHODS:329 consecutive male patients who had an orthotopic bladder replacement using the Z-shaped ileal neobladder between May 1990 and January 2009. RESULTS:The mean age of the patients was 64.4 ± 9.6 years, with a mean follow-up of 59.4 ± 55 months. Eighty-three early complications in 80/294 patients (27.2%) occurred. The average Clavian rate of these early complications was 2.24. Among these, 12 complications in 12 patients (4.1%) were pouch-related, and 3 reoperations were required. Two patients died from cardiac complications. Sixty-three late complications in 60/294 patients (20.4%) were recorded. The average Clavian rate of these late complications was 2.98. Among these, 47 complications in 45/294 patients (15.3%) were pouch-related, and 18 reoperations were required, essentially for ureteral anastomosis stricture. Satisfactory daytime urinary continence was achieved in 92% of patients. Daytime continence was obtained within, on average, 6.8 ± 16.4 months. The interval between each daytime urination was 2.6 ± 0.8 h (median = 2.5 [1-5] h). Forty-four (15%) patients developed metabolic acidosis which only required oral medication. Satisfactory nocturnal urinary continence was achieved in 87% of patients. Night-time continence was obtained within, on average, 10.8 ± 22.4 months. Hyper-continence with subsequent need for CISC was observed in 4%. CONCLUSION:In our series of 329 patients, compared with the other techniques, the Z-shaped ileal neobladder had an 'expected' complication rate for this high risk surgery with satisfactory daytime and night-time continence in nine out of ten patients.

journal_name

BJU Int

journal_title

BJU international

authors

Neuzillet Y,Yonneau L,Lebret T,Herve JM,Butreau M,Botto H

doi

10.1111/j.1464-410X.2010.10000.x

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

596-602

issue

eissn

1464-4096

issn

1464-410X

journal_volume

108

pub_type

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The Z-shaped ileal neobladder after radical cystectomy: an 18 years experience with 329 patients.