Радикальная цистэктомия: терапевтические аспекты предоперационной подготовки и ведения пациентов в раннем послеоперационном периоде

Abstract

to improve the results of radical cystectomy by optimization of patient preparation for surgery and early postoperative care. A total of 136 patients who underwent radical cystectomy and either orthotopic ileal neobladder or ileal conduit formation were included in the study. Brikkers operation was performed in 92 patients (76% men and 24% women) aged from 39 to 83 years, while in 44 patients (97.7% men, 2.3% women) aged from 32 to 75 years the Studer ileal neobladder was created. All patients underwent preoperative comprehensive examinations in order to determine type and extent of surgical treatment. A complication rate after radical cystectomy with urine derivation using bowel segment was 49.2%. Mortality rate in early postoperative period was 3.9%. An algorithm of postoperative care after radical cystectomy with formation of either orthotopic neobladder or ileal conduit and consideration of comorbid status and preparation which we have used in clinical practice was developed. According to the results, after implementation of algorithm of management in preoperative and early postoperative period a decrease in complications and mortality rate has been found.