Variants of heterotypic ileocystoplasty

Vasil'chenko M.I., Pogosyan R.R., Zabelin M.V., Semenyakin I.V., Samoylov A.S., Sergeev V.P., Kyzlasov P.S.

The paper is aimed at finding the ways of urine derivation after cystectomy. Maintenance of high quality of patient’s life is one of the key point to achieve when treating patients with organic lesion of the urinary bladder (in addition to treating cancer). In a series of cases, the formation of orthotropic neocystis after cystectomy is not possible, so the creation of a cavity with low intraluminal pressure enabling urinary retention is a preferred operation.

The aim of the study was to investigate the results of surgery of patients with organic pathologies of the bladder, which required cystectomy and urinary derivation using heterotypic surgery of the small intestine coupled with urinary neocystis.

Materials and methods. We have analyzed the results of treatment of 105 patients with verified urinary bladder cancer (stages T24N02N0x) after cystectomy and subsequent formation of heterotypic small intestinal neoccystis. In 35 patients (33.3%) the procedure was conducted by the method proposed by Vasilchenko M.I. et al. The modified method was applied to 35 patients (33.3%). Ileal conduit was performed in 35 patients (33.3%) by the method proposed by Bricker.

Results. Functional efficiency of the heterotypic urinary neocystis was evaluated after the surgery right after it and in the longterm period. The proposed method significantly improves and stabilizes the functional state of upper urinary tracts. We have revealed the advantages of heterotypic small intestinal neoccystis in comparison with ileal conduit.

Conclusions. The choice of the optimal way of urine diversion after urinary bladder amputation is not always an easy task. Thus, the decision should be made only during the surgery. The improvement of the quality of life of the patients who underwent heterotypic surgery of the small intestine is achieved by the increase in the volume of the cavity. This is possible after the decrease in the number of autocatheterizations.

Authors declare lack of the possible conflicts of interests.

AttachmentSize
Download972.08 KB
bladder cancer, cystectomy, ileocystoplasty