The "B-bladder"-an ileocolonic neobladder with a chimney: surgical technique and long-term results.
OBJECTIVE
A modified version of the "Le Bag" ileocolonic neobladder with a "Studer"-like ileal chimney (B-bladder) is presented. The surgical technique, perioperative complications, and long-term results, including cancer control and continence, are described.


METHODS
Twenty-nine patients underwent radical cystectomy and urinary diversion to an orthotopic ileocolonic neobladder with an ileal chimney. All operations were done by a single surgeon. Preoperative, perioperative and postoperative data were recorded. Median duration of follow-up was 3.4 years.


RESULTS
The operation was technically successful in all cases. Late complications included recurrent urinary tract infection (17%) and uretero-neobladder anastomotic stricture (3%), both at acceptable rates. Postoperative daytime continence was excellent. Cancer control was satisfactory during follow-up; 11 patients (38%) died of disease progression with distant metastases. Median survival was 71.1 months.


CONCLUSIONS
The B-bladder maintains the simplicity of preparation of the original "Le-Bag" neobladder while gaining the advantages of ureteral anastomosis to an ileal chimney. The incidence of perioperative complications is low and long-term results with regard to cancer control, continence, and complications are excellent.
Baniel
Jack
J
Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
Tal
Raanan
R
D000328:Adult; D000368:Aged; D003106:Colon / Q000637:transplantation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D016476:Urinary Reservoirs, Continent; D013520:Urologic Surgical Procedures / Q000379:methods*