The clinical study of urinary flow parameters after drag-and-bond anastomosis for ileal orthotopic neobladder reconstruction.

Abstract

To assess the viability of this procedure in laparoscopic radical cystectomy with ileal orthotopic neobladder reconstruction, the objective of this study is to examine the relationship between urinary flow parameters of urethral drag-and-bond anastomosis in the reconstruction of the ileal orthotopic neobladder. 36 patients with bladder cancer underwent laparoscopic radical cystectomy with ileal orthotopic neobladder reconstruction at Jiangxi provincial people's hospital between June 2016 and January 2021,16 patients underwent intermittent urethral anastomosis, while 20 patients underwent neobladder-urethral drag-and-bond anastomosis. The maximum bladder capacity, residual urine output, maximum urinary flow rate, and outlet morphology of the new bladder neck were all monitored throughout postoperative follow-up regularly. There was no significant difference between the urethral drag-and-bond anastomosis group (group A) and the conventional anastomosis group (group B) at 3months and 12months after surgery, and the maximum bladder capacity (3months, 488.35 ± 51.56ml vs 481.06 ± 40.61ml, t = -0.462, P = 0.647; 12months, 496.35 ± 51.09ml vs 476.56 ± 56.33ml, t = -1.103, P = 0.278), residual urine output (3months, 44.15 ± 24.12ml vs 38.69 ± 21.82ml, t = -0.704, P = 0.486;12months, 49.65 ± 26.95ml vs 36.75 ± 21.96ml, t = -1.546, P = 0.131) and maximum urine flow rate (3months, 12.36 ± 2.63ml/s vs 13.60 ± 2.82ml/s, t = 1.361, P = 0.182;12months, 12.18 ± 3.14ml/s vs 11.13 ± 3.01ml/s, t = -1.004, P = 0.322) of the two groups were not significant (P > 0.05). The new bladder outlet morphology was not distorted in group A patients, the continuity was good, and there were fewer associated complications. There was no significant difference in postoperative urodynamic parameters between the urethral drag-and-bond anastomosis group and the conventional anastomosis group, and the postoperative new bladder outlet was in good shape, with clinical significance.