Complication Analysis And Long-term Quality Of Life Assessment Following Radical Cystectomy And Orthotopic Diversion

Objective(s): Taking long term follow up of the patients undergoing radical cystectomy and orthotopic diversion, analyzing postoperative complications, using FACT-BL scale to assess the health-related quality of life in patients ,analyzing the results of long follow-up and providing a basis for further study of the operation of the orthotopic diversion?Methods: The clinical data of 68 patients who had undergone orthotopic ileal neobladder or orthotopic sigmoid neobladder from January 2014 to December 2016 in the Second Affiliated Hospital of Kunming Medical University. Analyzing the incidence of postoperative complications. Investigating and analyzing the HRQOL status after operation by using FACT-BL.Results: Of all the 68 patients received radical cystectomy and orthotopic diversion ,all of them completed long-term follow-up.The age of patients is between 39-79 years old, average 60.34±9.43 years old. The surgerywere successfully completed and postoperative recovery is good, all patients were discharged from hospital.Of the 68 patients who completed the follow-up, 10 patients (14.71%) had early complications, and 11 patients (17.64%) had late complications. Preoperative and postoperative serum Cr contrast (t=1.305, P=0.196),the difference between them were not statistically BUN contrast (t=0.358, P=0.764),before and after surgery (t=1.347,P=0.169),Na+ significant; Comparison of K+(t= -1.748,P=0.144), and Ca+(t= 1.097,P=0.319),(t= 4.701,P=0.000),difference was not statistically significant,Cl- contrast difference has statistical significance. By strengthening the urination function training, 56 cases (93.33%) were in good control during the day and 20 cases(33.33%) were not good at night after one years of follow-up. Six months after surgery, the capacity of the new bladder was (365. 02 ± 45. 11) ml,the maximum urinary flow rate was (14. 36 ± 1. 41) ml/s and residual urine volume was (26. 01±8.10) ml. Assessed by FACT-BL scale, after one years of follow-up, the FACT-BL score was 124. 8 ± 13. 4.Conclusion(s):After our long term follow up ,the early and late complications are within the acceptable range. The urine control rate of daily life and the night life of the patients with bladder cancer after operation can meet the requirements of daily life.There are less electrolyte balance disorder occurred in patients and pper urinary tract function recovered well. The neobladder is more close to the state of the urine storage, urination function. The integrity of the body appearance was preserved in orthotopic bladder operation and the neobladder's physiological characteristics are close to the normal bladder. Orthotopic ileocolon continent urinary reservoir might be considerd as an ideal from of urinary diversion.