Urinary Diversions after Cystectomy: The Association of Clinical Factors, Complications and Functional Results of Four Different Diversions

Nieuwenhuijzen, Jakko A.; Vries, R.R. de; Bex, A.; Poel, Henk G. van der; Meinhardt, W.; Antonini, Ninja; Horenblas, Simon

doi:10.1016/j.eururo.2007.09.008

Cited by 269 publications

(173 citation statements)

References 24 publications

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“…Moreover 92% and 87% of our patients do not require more than one pad by day and by night respectively. These rates are comparable to those reported in other series (Table 3) [14,[19][20][21][22][23][24][25][26][27][28][29]. They are overall complication rates and the severity of complications is not detailed in all these series, therefore the value of their comparison is limited.…”

Section: Discussionsupporting

confidence: 67%

“…We report rates of early and late complications related to the neobladder of respectively 4.4% and 17.7%. For these early complications, only three cases (1%) required surgical treatment (Table 3) [14,[19][20][21][22][23][24][25][26][27][28][29]. Moreover, early complications were generally self-limiting and managed conservatively with no impact on the overall outcome.…”

Section: Discussionmentioning

confidence: 99%

“…[20] 62 41% 59% 90% 67% 23% Jensen [21] 67 61% 48% 90% 65% 43% Koie [22] 96 21.0% 5.2% 91.6% 10.5% 2.1% Joniau [23] 58 38% 48% 95% 66% 9% Soulié [24] 55 24% 25% 89% 79% 6% Abol-Eneim [25] 450 9% 9% 93% 80% -Hollowell [26] 50 24% 20% 93% 86% 4% Hautmann [14] 363 39% 32% 96% 95% 6% Arai [27] 66 44% 22% 95% 67% 5% Studer [28] 200 12% 47% 92% 84% -Cancrini [29] 96 11% 23.9% 97% 83% -…”

Section: Conflict Of Interestmentioning

confidence: 99%

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The Z‐shaped ileal neobladder after radical cystectomy: an 18 years experience with 329 patients

et al. 2011

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Eighty-three early complications in 80/294 patients (27.2%) occurred. The average Clavian rate of these early complications was 2.24. Among these, 12 complications in 12 patients (4.1%) were pouch-related, and 3 reoperations were required. Two patients died from cardiac complications. Sixty-three late complications in 60/294 patients (20.4%) were recorded. The average Clavian rate of these late complications was 2.98. Among these, 47 complications in 45/294 patients (15.3%) were pouch-related, and 18 reoperations were required, essentially for ureteral anastomosis stricture.Satisfactory daytime urinary continence was achieved in 92% of patients. Daytime continence was obtained within, on average, 6.8 ± 16.4 months. The interval between each daytime urination was 2.6 ± 0.8 h (median = 2.5 [1-5] h). Forty-four (15%) patients developed metabolic acidosis which only required oral medication.Satisfactory nocturnal urinary continence was achieved in 87% of patients. Night-time continence was obtained within, on average, 10.8 ± 22.4 months.Hyper-continence with subsequent need for CISC was observed in 4%. CONCLUSIONIn our series of 329 patients, compared with the other techniques, the Z-shaped ileal neobladder had an 'expected' complication rate for this high risk surgery with satisfactory daytime and night-time continence in nine out of ten patients.

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Section: Discussionsupporting

confidence: 67%

Section: Discussionmentioning

confidence: 99%

Section: Conflict Of Interestmentioning

confidence: 99%

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The Z‐shaped ileal neobladder after radical cystectomy: an 18 years experience with 329 patients

et al. 2011

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“…In addition, we note no significant difference in stricture rates in patients who received radiotherapy compared to patients who did not. Although previous data have suggested that radiotherapy is not a predictor for the development of ureteroenteric strictures, 22 one study has demonstrated a trend for higher stricture rates in patients previously treated with radiotherapy as expected. 10 A subgroup analysis of ureteroenteric stricture rates in irradiated Bricker and Wallace arms was not performed as this data were only recorded in one study.…”

Section: Discussionmentioning

confidence: 93%

“…22 Our meta-analysis demonstrates no significant differences in patient demographics between groups. In addition, we note no significant difference in stricture rates in patients who received radiotherapy compared to patients who did not.…”

Section: Discussionmentioning

confidence: 96%

Bricker versus Wallace anastomosis: A meta-analysis of ureteroenteric stricture rates after ileal conduit urinary diversion

Davis

Burke

McDermott

et al. 2015

CUAJ

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Introduction: Data comparing the incidence of ureteroenteric strictures for Bricker and Wallace anastomoses are limited. This study compares both anastomotic techniques in terms of ureteroenteric stricture rates after radical cystectomy and ileal conduit urinary diversion. Methods: Electronic databases (Medline, EMBASE, and Cochrane database) were searched for studies comparing Bricker and Wallace ureteroeneteric anastomoses for ileal conduit urinary diversion after radical cystectomy. Meta-analyses were performed using the random effects method. The primary outcome measure was to determine differences in postoperative ureteroenteric stricture rates for both surgical techniques. Four studies describing 658 patients met the inclusion criteria. The total number of ureters used for ureteroeneteric anastomoses was 1217 (545 in the Bricker group and 672 in the Wallace group). Results: There were no significant differences in age (p = 0.472), gender (p = 0.897), duration of follow-up (p = 0.168), and duration to stricture development between groups (p = 0.439). The overall stricture rate was 29 of 1217 (2.4%); 16 of 545 ureters (2.9%) in the Bricker group and 13 of 672 ureters (1.9%) in the Wallace group. The Bricker anastomosis was not associated with a significantly higher overall stricture rate compared to the Wallace ureteroenteric anastomosis (odds ratio: 1.393, 95% confidence interval: 0.441-4.394, p = 0.572).

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Bladder Cancer

Lenis

Lec

Chamie³

et al. 2020

JAMA

1,040

812

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ImportanceBladder cancer is a common malignancy in women and is the fourth most common malignancy in men. Bladder cancer ranges from unaggressive and usually noninvasive tumors that recur and commit patients to long-term invasive surveillance, to aggressive and invasive tumors with high disease-specific mortality.ObservationsAdvanced age, male sex, and cigarette smoking contribute to the development of bladder cancer. Bladder tumors can present with gross or microscopic hematuria, which is evaluated with cystoscopy and upper tract imaging depending on the degree of hematuria and risk of malignancy. Non–muscle-invasive tumors are treated with endoscopic resection and adjuvant intravesical therapy, depending on the risk classification. Enhanced cystoscopy includes technology used to improve the detection of tumors and can reduce the risk of recurrence. Patients with high-risk non–muscle invasive tumors that do not respond to adjuvant therapy with the standard-of-care immunotherapy, bacille Calmette-Guérin (BCG), constitute a challenging patient population to manage and many alternative therapies are being studied. For patients with muscle-invasive disease, more aggressive therapy with radical cystectomy and urinary diversion or trimodal therapy with maximal endoscopic resection, radiosensitizing chemotherapy, and radiation is warranted to curb the risk of metastasis and disease-specific mortality. Treatment of patients with advanced disease is undergoing rapid changes as immunotherapy with checkpoint inhibitors, targeted therapies, and antibody-drug conjugates have become options for certain patients with various stages of disease.Conclusions and RelevanceImproved understanding of the molecular biology and genetics of bladder cancer has evolved the way localized and advanced disease is diagnosed and treated. While intravesical BCG has remained the mainstay of therapy for intermediate and high-risk non–muscle-invasive bladder cancer, the therapeutic options for muscle-invasive and advanced disease has expanded to include immunotherapy with checkpoint inhibition, targeted therapies, and antibody-drug conjugates.

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Urinary Diversions after Cystectomy: The Association of Clinical Factors, Complications and Functional Results of Four Different Diversions

Cited by 269 publications

References 24 publications

The Z‐shaped ileal neobladder after radical cystectomy: an 18 years experience with 329 patients

The Z‐shaped ileal neobladder after radical cystectomy: an 18 years experience with 329 patients

Bricker versus Wallace anastomosis: A meta-analysis of ureteroenteric stricture rates after ileal conduit urinary diversion

Bladder Cancer

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