[Laparoscopic cystectomy and ileal conduit urinary diversion for neurogenic bladders and related conditions. Morbidity and better quality of life].
OBJECTIVE
To assess morbidity and functional consequences of laparoscopic cystectomy with ileal conduit urinary diversion: in neurologic patients.


METHODS
We reviewed the records of forty-two patients (ten men and thirty-two women) who underwent surgery between August 2007 and October 2013. The median age of the patient was 54 years old (range between 21-79 years). A laparoscopic cystectomy was performed followed by a short laparotomy to perform the ileal conduit urinary diversion. Records were reviewed to retrieve the indications and describe the postoperative and functional course. Patients and GPs were interviewed during phone calls to appreciate the quality of life by the PGII scale in order to assess the functional outcome.


RESULTS
The operation was performed on 42 patients, of whom 18 had multiple sclerosis, nine a post-traumatic neurogenic bladder. Among the total population, 10 patients (23.81%) required a transfusion of at least one packed red blood cells (1-7). The overall rate of early complications was 35.71%. Belated complications were seen in 52.38% of the population. The median duration of hospital stay was 16 days (range between 9-70 days). The median follow up was 34 months (range between 1-76 months). For patients, the PGII scale rating had a median value of 6 (2-7). All referring physicians described a better functional status.


CONCLUSIONS
The laparoscopic cystectomy can make postoperative course smoother for the neurological patients. However, the surgeon must weigh individually the benefit of performing the operation.
Service d'urologie, hôpital Robert-Debré, avenue du Général-Koenig, 51092 Reims, France. Electronic address: redhasakhri@hotmail.com.
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R
Sakhri
Service d'urologie, nouvel hôpital civil, 1, place de l'Hôpital, 67000 Strasbourg, France. Electronic address: frederic.seigle-murandi@chru-strasbourg.fr.
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F
Seigle-Murandi
Service d'urologie, nouvel hôpital civil, 1, place de l'Hôpital, 67000 Strasbourg, France. Electronic address: didier.jacqmin@chru-strasbourg.fr.
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D
Jacqmin
Service d'urologie, nouvel hôpital civil, 1, place de l'Hôpital, 67000 Strasbourg, France. Electronic address: herve.lang@chru-strasbourg.fr.
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H
Lang
Service d'urologie, nouvel hôpital civil, 1, place de l'Hôpital, 67000 Strasbourg, France. Electronic address: christian.saussine@chru-strasbourg.fr.
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C
Saussine
D000328:Adult; D000368:Aged; D015653:Cystectomy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D001750:Urinary Bladder, Neurogenic / Q000150:complications / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects; D055815:Young Adult
Cystectomie laparoscopique; Laparoscopic cystectomy; Morbidity; Morbidité; Neurogenic bladder; Quality of life; Qualité de vie; Vessie neurologique