論文

査読有り 国際誌
2014年6月

Comparison of 90-day complications between ileal conduit and neobladder reconstruction after radical cystectomy: a retrospective multi-institutional study in Japan.

International journal of urology : official journal of the Japanese Urological Association
  • Takashige Abe
  • ,
  • Norikata Takada
  • ,
  • Nobuo Shinohara
  • ,
  • Ryuji Matsumoto
  • ,
  • Sachiyo Murai
  • ,
  • Ataru Sazawa
  • ,
  • Satoru Maruyama
  • ,
  • Kunihiko Tsuchiya
  • ,
  • Shino Kanzaki
  • ,
  • Katsuya Nonomura

21
6
開始ページ
554
終了ページ
9
記述言語
英語
掲載種別
DOI
10.1111/iju.12357

OBJECTIVE: To determine the differences in the type, incidence, and severity of 90-day morbidity after radical cystectomy between two different methods of urinary diversion, ileal conduit and neobladder. METHODS: We carried out a retrospective multi-institutional study by reviewing the records of 668 patients treated with open radical cystectomy, and ileal conduit (n = 493) or neobladder substitution (n = 175) between 1997 and 2010. All complications within 90 days after surgery were divided into 11 specific categories as reported by the Memorial-Sloan Kettering Cancer Center, and graded according to the modified Clavien system. Type, incidence and severity of the 90-day morbidity between the two different types of urinary diversions were compared. RESULTS: There was no significant difference in the overall complication rates between the two groups (ileal conduit: 72% [353/493], neobladder: 74% [129/175], P = 0.5909), whereas the neobladder group had fewer major (grade 3 or more) complications (13 vs 20%, respectively, P = 0.0271). The neobladder group had more infectious complications (43 vs 31%, respectively, P = 0.0037), mainly as a result of urinary tract infection, whereas the ileal conduit group had more wound-related complications (24 vs 14%, respectively, P = 0.0068), mainly as a result of surgical site infection. The 90-day mortality rates were 1.1% (2/175) in the neobladder group and 1.6% (8/493) in the ileal conduit group (P = 0.6441). CONCLUSIONS: There was no significant difference in the overall complication rates between the two methods, and patients with neobladder had fewer major complications. The neobladder group had more infectious complications, whereas the ileal conduit group had more wound-related complications.

リンク情報
DOI
https://doi.org/10.1111/iju.12357
PubMed
https://www.ncbi.nlm.nih.gov/pubmed/24304154

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