IS NEOBLADDER SAFE FOR HIGH GRADE BLADDER CANCER PATIENTS?: EVALUATION OF RADICAL CYSTECTOMY COMPLICATIONS AND ILEAL NEOBLADDER RECONSTRUCTION IN AMC KARIADI GENERAL HOSPITAL

Irene Stephanie, Mohamad Adi Soedarso

Abstract


Objective: The purpose of this study was to evaluate complications of ileal neobladder reconstruction in high grade bladder cancer patients. Material & Methods: The descriptive study included 12 patients who underwent radical cystectomy and bladder reconstruction with ileal neobladder in Academic Medical Center Kariadi General Hospital Semarang from 2009 until 2016. Base data recorded retrospectively and followed at outpatient clinic. The complications were evaluated from perioperative care, postoperative care, and outpatients clinic. Clavien Dindo classification use to rank complication. Results: The average ages distribution range from 39-70 year. There were 2 patients with comorbid of renal failure, 11 patients with history of TUR and 1 patient underwent adjuvant external radiation. There were 11 patients in high grade bladder cancer (≥T3) and 1 patient with T2. Of the 8 patients underwent orthotopic neobladder procedure and 3 patients underwent cutaneous w-shape procedure. From the histopathology results, 10 patients with high grade transitional cell carcinoma, and 2 patients with invasive urothelial cell carcinoma. There were complication caused by neobladder-related of 1 patient with urinary leakage from ureteroileal anastomose, 1 patient with peritonitis caused by ileo-ileal anastomose leakage, and 1 patients with bowel necrosis caused by internal hernia who need re-operation. All neobladder related complication were 4/33%. From neobladder nonrelated of 1 patient with chronic renal disease and sepsis, and 1 patient with acute renal failure and hyperchlor metabolic acidosis. All of neobladder related complications described above end with mortality (2/16%), except the urinary leakage. Conclusion: Our complication and mortality radical cystectomy - neobladder related rate were 33% and 16% compare with literature show 28-64% and 5.1-8.1%, respectively. Patients selection (<T3, no comorbid) and experience according high volume operation can reduced the mortality rate.


Keywords


Bladder cancer; orthotopic neobladder; radical cystectomy

Full Text:

PDF

References


Stein JP, Lieskovsky G, Cote R. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J Clin Oncol. 2001; 19: 666–75.

Carrion R, Seigne J. Surgical management of bladder carcinoma. Cancer Control. 2002; 9: 284–92.

Knap MM, Lundbeck F, Overgaard J. Early and late treatment-related morbidity following radical cystectomy. Scand J Urol Nephrol. 2003; 38: 153–60.

AS Zakaria, F Santos, A Dragomir, S Tanguay, W Kassouf, AG Aprikian. Postoperative mortality and complications after radical cystectomy for bladder cancer in Quebec: a population-based analysis during the years 2000–2009. Canadian Urological Association Journal. 2014; 8(7-8): 259–67.

LS Hounsome, J Verne, JS McGrath, DA Gillatt. Trends in operative caseload and mortality rates after radical cystectomy for bladder cancer in England for 1998–2010. European Urology. 2015; 67(6): 1056–62.

A Shabsigh, R Korets, KC Vora. Defining early morbidity of radical cystectomy for patients with bladder cancer using a standardized reporting methodology. European Urology. 2009; 55(1): 164–76.

RE Hautmann, RC dePetriconi, BG Volkmer. Lessons learned from 1,000 neobladders: the 90-day complication rate. The Journal of Urology. 2010; 184(3): 990–4.

Stein JP, Skinner DG. Orthotopic urinary diversion. In: Walsh PC, Retik AB, Vaughan ED, Wein AJ, editors. Campbell’s Urology, 8th Ed. Philadelphia: Saunders. 2002; 4: 3835–67.

Hautmann RE, Paiss T. Does the option of the ileal neobladder stimulate patient and physician toward earlier cystectomy? J Urol. 1998; 159: 1845–50.

Hautmann RE, Volkmer BG, Schumacher MC, Gschwend JE, Studer UE. Long-term results of standard procedures in urology: the ileal neobladder. World J Urol. 2006; 24: 305-14.

Hautmann RE, de Petriconi R, Gottfried HW, Kleinschmidt K, Mattes R, Paiss T. The ileal neobladder: complications and functional results in 363 patients after 11 years of follow-up. J Urol. 1999; 161: 422–8.

RD Mills, UE Studer. Metabolic consequences of continent urinary diversion. Journal of Urology. 1999; 161(4): 1057–66.

F Van der Aa, S Joniau, M Van Den Branden, H Van Poppel. Metabolic changes after urinary diversion. Advances in Urology; 2011: 5. Article ID 764325.




DOI: http://dx.doi.org/10.32421/juri.v26i1.435

Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.

Index by: