Orthotopic Ileal Neobladder Versus Ileal Conduit Urinary Diversion-perioperation And Prognoses Based Comparison

Objective: To compare the perioperation and prognoses between patients who underwent orthotopic ileal neobladder or ileal conduit urinary diversion following radical cystectomy.Materials and Methods: From March 2007 to February 2015, 68 patients(42 males and 9 females) of muscle invasive carcinoma urinary bladder(mean age 62.3 years) were operated upon by radical cysto- prostatectomy and urinary diversion was performed by ileal conduit or orthotopic ileal neobladder. 32 orthotopic ileal neobladder and 19 ileal conduit. Post-operative hospital stay, perioperation, early and late complications, and HRQOL were evaluated on follow up.Results: No difference was found(P>0.05) regarding age, BMI, pathological grading and stage, chronic diseases, hospitalization expenses. The IN groups had significantly longer post-operative hospital stay than the BR groups. No difference was found(P>0.05) regarding operative time, lymph node cleaning number, intestinal function recovery time, postoperative start activity time, analgesic requirement. Early complications(within 1 month of surgery) were observed in 31.6% of patients in ileal conduit group and 46.9% in ileal neobladder group. Late complications(after 1 month of surgery) were seen in 15.8% of patients in ileal conduit group and 34.4% in ileal neobladder group. But all difference had no statistical significance(P>0.05).The two patient groups did not differ significantly in the results of the global health status/quality of life.4 functions(physical, role, emotional, and social functioning) are also better performed by patients with ileal neobladder than by those with ileal conduit and had differ statistical significance.Conclusions: Orthotopic ileal neobladder had more difficult in operating procedure than ileal conduit urinary, and its rate of complication higher than that of group BR. However, the two patient groups did not differ significantly in the results of the global health status/quality of life. In conclusion, doctors should be according to the patients condition and the requirements of the quality of life, providing patients with the mostappropriate urinary diversion, and explaining to the patient the advantages and disadvantages of different urinary diversion.