title: Ileal conduit: standard urinary diversion for elderly patients undergoing radical cystectomy.
abstract: OBJECTIVE
  Ileal conduit (IC) is the most frequent urinary diversion (UD) performed after radical cystectomy (RC). We reviewed the literature to investigate the factors influencing the choice of this diversion and its complications.
  
  
  METHODS
  A literature search (PubMed) was performed for all English language publications on UDs performed for treatment of bladder cancer from 1950 to 2015. The literature review was focused on studies reporting outcome of IC and its comparison with other types of UDs.
  
  
  RESULTS
  IC is the most common UD performed in elderly patients undergoing RC for bladder cancer. Long-term studies looking at the change in renal function after UD report a universal decline in the glomerular filtration rate; however, this decline in renal function is the least for IC. There is a significant morbidity of RC (20-56 %), which can be attributed to patient factors, surgical technique and hospital volume. Modern concepts of bowel preparation, postoperative nutrition, early enteral feeding and involvement of stoma therapists have helped improve the outcomes. The quality of life is preserved, and in many including elderly, it may be improved with IC UD.
  
  
  CONCLUSIONS
  IC is the most commonly performed UD following radical cystectomy. It is associated with acceptable morbidity and has the lowest reoperation rates as compared to continent diversion. It is also the procedure of choice for most patients' elderly patients as well as patients with limited dexterity, poor motivation, anatomical restrictions and poor renal function. Studies measuring HRQOL report excellent patient acceptability, especially in the elderly population.
authors.affiliation: Departments of Surgery, Oncology and Pathology, Divisions of Urology and Surgical Oncology, Schulich School of Medicine & Dentistry, London Health Sciences Centre-Victoria Hospital, Western University, 800 Commissioners Road East, Room E2-649, London, ON, N6A 5W9, Canada.
authors.forename: Khurram M
authors.initials: KM
authors.lastname: Siddiqui
authors.affiliation: Departments of Surgery, Oncology and Pathology, Divisions of Urology and Surgical Oncology, Schulich School of Medicine & Dentistry, London Health Sciences Centre-Victoria Hospital, Western University, 800 Commissioners Road East, Room E2-649, London, ON, N6A 5W9, Canada. jonathan.izawa@lhsc.on.ca.
authors.forename: Jonathan I
authors.initials: JI
authors.lastname: Izawa
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002295:Carcinoma, Transitional Cell / Q000473:pathology / Q000601:surgery*; D015653:Cystectomy / Q000379:methods*; D005919:Glomerular Filtration Rate; D006761:Hospitals; D006801:Humans; D009130:Muscle, Smooth / Q000473:pathology; D009361:Neoplasm Invasiveness; D011183:Postoperative Complications; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*
keywords: Elderly patients; Ileal conduits; Muscle invasive bladder cancer; Radical cystectomy; Urinary diversions