Clinical Observation Of Three Types Of Urinary Diversions After Radical Cystectomy In 65 Patients With Bladder Cancer

Objective:To evaluate orthotropic ieal neobladder,Bricker,ureterostomy three types of urinary diversions after radical cystectomy,compare the clinical efficacy and life quality of three operations.Methods : Collecting the clinical data of 65 patients with urinary diversions after radical cystectomy from September 2009 to March 2012 in our hospical,including 34 cases with orthotropic ieal neobladder,16 cases with Bricker,15 cases with cystectomy.Operation time,bleeding,recovery time,short and long-term complication,survival rate at one-year and three-year are summarized,also to compare the life quality scores use the SF-36.Results:There were no statistically significant difference in gender, clinical stage,pathological grading(P > 0.05),but the age of three groups was significant difference(62.71+2.48vs66.00+3.014vs75.67+1.633years), the ureterostomy group were older than the other two groups(P<0.05). All three groups of Operation were successful,there were statistically significant difference in operation time,bleeding,recovery time(P <0.05),the ureterostomy group is the shortest one in the operation time,bleeding,recovery time of three groups,but there were no statistically significant difference between ieal neobladder and Bricker groups. No severe electrolyte disturbance happend in short time,Urinary tract infection was more often in the ureterostomy and anastomotic fistula was a commom complication in ieal neobladder and Bricker groups, there were no statistically significant difference in total short and long-term complications,survival rate at one-year and three-year of three groups(P>0.05).Patients treated with orthotropic ieal neobladder have a higher life quality scores than the Bricker and ureterostomy patients(P<0.05).Conclusions:Radical cystectomy is an effective operation in treating muscle-invasive bladder cancer and multiple recurrent bladder cancer.Orthotropic ieal neobladder with a few complications after operation and high life quality,approximate the physiologicalurination;ureterostomy procedure is relatively simple,but the incidence of urinary tract infection is higher;Bricker can protect the renel function better,but patients has a lower life quality than the orthotropic ieal neobladder group.