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근치적 방광적출술 후 정위성 회결장 방광대치술과 회장 방광대치술의 합병증 및 요역동학적 검사의 비교

Comparison of the Complications and Urodynamic Parameters for Orthotopic Bladder Substitution with using Ileocolic or Ileal Segments after Radical Cystectomy

대한비뇨기과학회지 2007년 48권 5호 p.494 ~ 499
조강준 ( Cho Kang-Jun ) - 가톨릭대학교 의과대학 비뇨기과학교실

손동완 ( Sohn Dong-Wan ) - 가톨릭대학교 의과대학 비뇨기과학교실
김세웅 ( Kim Sae-Woong ) - 가톨릭대학교 의과대학 비뇨기과학교실

Abstract


Purpose: The objective of this study was to compare the complications and urodynamic parameters of the patients who underwent orthotopic bladder substitution with using ileocolic or ileal segments after radical cystectomy for treating invasive bladder cancer.

Materials and Methods: Between January 1990 and April 2006, 260 patients with invasive bladder cancer underwent radical cystectomy and construction of the urinary diversion; ileal conduit, indiana pouch, ileocolic neobladder, ileal neobladder were all done at St. Mary’s Hospital. The mean age of the patient was 61.8 years(range: 46-86). The ratio of male and female was 88%/12%. Forty nine patients received an orthotopic ileocolic neobladder and 45 patients received an orthotopic ileal neobladder. The complications and urodynamic parameters were compared in both groups.

Results: The orthotopic ileocolic neobladder after radical cystectomy for treating invasive bladder cancer has been performed between 1990 and 1996 and the orthotopic ileal neobladder has been performed between 1996 and 2006. Ileocolic neobladder related complications developed in 10 patients; neobladder leakage in 1(2%), neobladder rupture in 1(2%), stricture of the ureteroenteric anastomosis site in 4(8.2%), and stricture of the urethral anastomosis site in 4(8.2%). Ileal neobladder related complications developed in 11 patients; ureteroenteric stricture in 7(15.5%), stricture of the urethral anastomosis site in 3(6.6%) and acute pyelonephritis in 1(2.2%). The results of the mean maximal flow rate and mean postvoid residual volume were better in the ileal neobladder group than those in the ileocolic neobladder group.

Conclusions: There were no significant differences in complications between ileocolic neobladder and ileal neobladder. The maximal uroflow and residual urine volume of the ileal neobladder were superior to those of the ileocolic neobladder on urodynamic study.(Korean J Urol 2007; 48:494-499)

키워드

Urinary diversion;Ileum;Colon;Urodynamics;Complications
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