AB129. Clinical analysis about 21 cases of different urinary diversion after radical cystectomy

Objective: To compare the clinical effects and surgical complications of different urinary diversion in the patients who underwent radical cystectomy.

Methods: Retrospective analysis clinical data, surgical complications of short and long-term of 21 patients with radical cystectomy (11 with orthotopic sigmoid neobladder, 2 with orthotopic ileal neobladder, 6 with ureterocutaneostomy and 2 with sigma rectum pouch) in our hospital during the past 10 years.

Results: Follow up had been made in 6–120 months, and all patients recovered smoothly and there was no tumor recurrence. After 6 month of the operation, no hydronephrosis was found in all cases. There were no significant differences in operation time, median blood loss and hospitalization between orthotopic sigmoid neobladder group and orthotopic ileal neobladder group (P>0.05). And there were significant difference in operation time, median blood loss and the rate of early complications between ureterostomy and other groups (P<0.05). The daytime and nighttime continent rate was 100% and 100% 6 months after the operation in orthotopic sigmoid neobladder group.

Conclusions: Different urinary diversions have their own advantages. We should select the appropriate operation according to the individual condition of the patient, to improve patient survival and quality of life. Sigmoid neobladder as an ideal form of orthotopic urinary reconstruction comes closest to the natural bladder’s urine storage and voiding function. When involvement of the urethra by tumour prevents the choice of an orthotopic neobladder, sigma rectum pouch will be accepted by more and more people as a continent cutaneous diversion. For elderly patients and those with a poor performance status, the ureterocutaneostomy is a reliable option.

Keywords: Cystectomy; urinary diversion