V1892 EARLY RESULTS WITH A TOTALLY EXTRAPERITONEAL ILEAL CONDUIT

Abstract

You have accessJournal of UrologyOncology, Bladder Oncology1 Apr 2012V1892 EARLY RESULTS WITH A TOTALLY EXTRAPERITONEAL ILEAL CONDUIT Rolf Gillitzer, Mehran Farasaty-Ghazwiny, Johannes Fritsch, Jörg Schede, and Christian Hampel Rolf GillitzerRolf Gillitzer Darmstadt, Germany More articles by this author , Mehran Farasaty-GhazwinyMehran Farasaty-Ghazwiny Darmstadt, Germany More articles by this author , Johannes FritschJohannes Fritsch Darmstadt, Germany More articles by this author , Jörg SchedeJörg Schede Darmstadt, Germany More articles by this author , and Christian HampelChristian Hampel Mainz, Germany More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2047AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Incontinent urinary diversion continues to be the most widely used diversion type. Even with improved perioperative clinical care pathways, urinary diversion remains a morbid procedure. In order to improve perioperative reconvalescence and minimize bowel complications formation of a totally extraperitoneal ileal conduit is presented. METHODS 10 patients (8 male, 2 female) received radical cystectomy with extended pelvic lymphadenectomy and totally extraperitoneal ileal conduit for muscle invasive bladder cancer. Perioperative data was prospectively collected. RESULTS Mean patient age was 71 years (58 – 80) and the mean age-related Charlson comorbidity index 5.8 (3 – 8). Mean body mass index was 26.2 (18.9 – 32.7). 4/10 patients had previous abdominal surgery including one appendectomy case. No intraoperative complications occurred. Mean pathologist lymph node count was 18.3 (8 – 24). The gastric tube was clamped on the first postoperative day in every patient and removed the following day. 1/10 patients required gastric tube reinsertion. Mean time to bowel movement was 3.7 days (1 – 6). Pelvic drains were removed after a mean of 8.1 days (5 – 12). An asymptomatic postoperative lymphocele was diagnosed in 2/10 patients, but none required drainage. 5/10 patients had postoperative complications Clavien grade ≤ 2. One patient died postoperatively of myocardial infarction. Mean follow-up was 5.1 months (1 – 13). One patient was readmitted to the hospital within 90 days due to apoplectic insult. One patient had ureteric reimplantation of the left ureter eight months after cystectomy. CONCLUSIONS Tailoring of a totally extraperitoneal ileal conduit is feasible and can expedite postoperative recovery after cystectomy without being associated with a worrisome complication rate. However, pelvic drain indwelling time after extended lymphadenectomy can be prolonged. © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e763 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rolf Gillitzer Darmstadt, Germany More articles by this author Mehran Farasaty-Ghazwiny Darmstadt, Germany More articles by this author Johannes Fritsch Darmstadt, Germany More articles by this author Jörg Schede Darmstadt, Germany More articles by this author Christian Hampel Mainz, Germany More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...