Evaluation of 126 radical cystectomy with orthotopic ileal or sigmoidocolic neobladder

Abstract

To evaluate the long-term clinical effects of orthotopic ileal or sigmoidocolic neobladder. One hundred and twenty six patients with bladder cancer who underwent radical cystectomy and orthotopic ileal or sigmoidocolic neobladder from 1989 to 2001 were followed up, the clinical data was collected and analysed. Hautmann orthotopic ileal neobladder was performed on 84 cases and orthotopic sigmoidocolic neobladder was performed on 42 cases; Lymph node clearing during surgery was performed on 62 cases, chemotherapy and radiotherapy was performed on 64 cases after surgery. The continence and complications were compared between sigmoidocolic group and ileal group, the tumor recurrent rate and the 5-year survival rate were compared between lymphnode clearing group and chemoradical therapy group. Complete follow up was performed in 122 cases. Ureter broaden and urine backflow rate were higher in sigmoidocolic group than in ileal group (P < 0.05), nocturnal continence rate in sigmoidocolic group was higher than in ileal group (P < 0.05); Post-surgical tumor recurrent rate in lymphnode clearing group was lower than in chemoradical therapy group (P < 0.05), the 5-year survival rate in lymphnode clearing group was higher than in chemoradical therapy group (P < 0.05). The overall short-term complication rate was 15.9% (20/126), the overall long-term complication rate was 9.8% (12/122). The effects of orthotopic ileal or sigmoidocolic neobladder were satisfactory with low complication rate, lymphnode clearing during the surgery can increase the 5-year survival rate when compared with the chemoradical group.