Efficacy Comparison Of Orthotopic Urinary Diversion Between Ileal Neobladder And Sigmoid Neobladder

Objective:To investigate the therapeutic effects of radical cystectomy, compare the clinical of orthotopic ileal neobladder versus orthotopic sigmoid neobladder. Analyze the prophylaxis and treatment of perioperation and postoperative complications.Methods:The clinical data of53patients who had undergone orthotopic ileal neobladder and38patients who had undergone orthotopic sigmoid neobladder from January2009to December2012in the Second Affiliated Hospital of Kunming Medical University. Compare the time of operation, bleeding volume, and postoperative hospitalization duration. Analyze the causes, prophylaxis and treatment of the perioperation and postoperative complications. Estimate quality of life, function of neobladder, and urinary continence between two groups.Results:89patients are available to be followed up with the follow-up rate97.8%. They were followed up for a mean time of33.4months (rangel2-59months). There was no significant difference in the age, sex, clinical stage, bleeding volume and blood transfusion volume between the two groups. Tumor recurred in1case of ileal neobladder group, but non in sigmoid neobladder group. Compare with ileal neobladder group, sigmoid neobladder group had shorter operative time and postoperative hospitalization duration (p<0.01). Ileal neobladder provide large capacity, while sigmoid neobladder can obtain more urinary flow rate and less residual urine (p<0.05). Both two groups provide well urinary continence ability, urinary continence achieved84.2%-88.2%at daytime and52.6%-60.8%at night.Conclusions:Ileal neobladder or sigmoid neobladder orthotopic diversion provide good urinary diversion after radical cystetomy, especially for the patients whom expected long-term survival and higher quality of life. Both kinds of the surgical offer reliable curative effect, fewer complications and high rate of urinary control.