[Cystectomy followed by cecocystoplasty: functional and oncologic results. An experience of 101 cases].
From 1979 to 1992, 101 radical cystectomy with caecoplasty were performed by the same operator (MR). Mean age of the patients was 62 years with a sex-ratio: 10 males/1 female. The indications were: Transitional Cell Carcinoma in 89 cases, neurologic bladder in 5 cases, interstitial cystitis in 3 cases tuberculosis bladder in 3 cases and lymphoma in one case. The operative mortality was 3% and postoperative morbidity was 8%. The surgical procedure consisted of performing a neo-bladder with ileocaecal segment. The technique of ureterocaecal implantation changed during the study period. On a functional point of view, 28 ureterocaecal stenosis were reported (15%). It were rare (2.4%) with the last ureterocaecal anastomosis technique. The diurnal continence rate was 100%. The nocturnal continence rate was only 25%. On uroflowmetric point of view, the detubularization permitted to obtain low pressure bladders with 15% rate of atonic bladder. Transverse taeniamyotomy of the caecum permitted to increase the uroflowmetric performance of the bladder without atonic risk. The 5 and 10 year overall actuarial survival rate were respectively 5% and 30%. Tumoral stage was a significant prognostic factor. An adjuvant chemotherapy was performed in 28 patients. The 5 year actuarial survival rate of the patients with a chemotherapy was 82% versus 28% for the patients without chemotherapy (p < 0.01). Caecocystoplasty after radical cystectomy was a reliable technique in our experience.
Rampal
M
M
Service d'Urologie, Hôpital de la Timone, Marseille.
Bretheau
D
D
Truong Thi
T
T
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000009:adverse effects; D002295:Carcinoma, Transitional Cell / Q000601:surgery; D002432:Cecum / Q000637:transplantation*; D017024:Chemotherapy, Adjuvant; D002940:Circadian Rhythm; D003251:Constriction, Pathologic / Q000209:etiology; D015653:Cystectomy / Q000009:adverse effects / Q000534:rehabilitation; D018856:Cystitis, Interstitial / Q000601:surgery; D005260:Female; D006801:Humans; D008223:Lymphoma / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015996:Survival Rate; D014401:Tuberculosis, Urogenital / Q000601:surgery; D014513:Ureter / Q000601:surgery; D014515:Ureteral Diseases / Q000209:etiology; D001745:Urinary Bladder Diseases / Q000382:microbiology / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D001750:Urinary Bladder, Neurogenic / Q000601:surgery; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects; D014554:Urination; D014563:Urodynamics
Cystectomies suivies de caecocystoplasties: résultats fonctionnels et carcinologiques. Une expérience de 101 cas.