Urinary diversion and bladder reconstruction/replacement using intestinal segments for intractable incontinence or following cystectomy

Cody, June D; Nabi, Ghulam; Dublin, Norman; McClinton, Samuel; Neal, David E.; Pickard, Robert; Yong, Sze Ming

doi:10.1002/14651858.cd003306.pub2

Cited by 78 publications

(42 citation statements)

References 42 publications

(4 reference statements)

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“…Without an established health related quality of life benefit,[28] and low performance rates in our own and other population based studies,[29] receipt of continent diversion as a quality indicator is controversial and will unlikely reach consensus among experts. One could argue that, if possible to ascertain, a more appropriate process measure would be documentation of an informed discussion regarding the risks and benefits of continent diversion for a patient without contraindication.…”

Section: Discussionmentioning

confidence: 99%

Variation in performance of candidate surgical quality measures for muscle‐invasive bladder cancer by hospital type

et al. 2014

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Objective To test the association between hospital type and performance of candidate quality measures for treatment of muscle invasive bladder cancer (MIBC) using a large national tumor registry. Proposed quality measures include receipt of neoadjuvant chemotherapy, timely treatment, adequate lymph node dissection, and continent urinary diversion. Methods Using the National Cancer Database (NCDB), patients with stage ≥II urothelial carcinoma treated with radical cystectomy (RC) from 2003–2010 were identified. Hospitals were grouped by type and annual RC volume: community, comprehensive low volume (CLV), comprehensive high volume (CHV), academic low volume (ALV), and academic high volume (AHV) groups. Logistic regression models were used to test the association between hospital group and performance of quality measures, adjusting for year, demographic, and clinical/pathologic characteristics; generalized estimating equations were fitted to the models to adjust for clustering at the hospital level. Results 23,279 patients underwent RC at community (12.4%), comprehensive (CLV: 38%; CHV: 5%), and academic (ALV: 17%; AHV: 28%) hospitals. While only 0.8% (n=175) of patients met all 4 quality criteria, 61% of patients treated at AHV hospitals met ≥2 quality metric indicators compared to ALV (45%), CHV (44%), CLV (38%), and community (37%) hospitals (p<0.001). Following adjustment, patients were more likely to receive ≥2 quality measures when treated at AHV (OR 2.4 [CI 2.0–2.9]), ALV (OR 1.3 [CI 1.1–1.6]), and CHV (OR 1.3 [CI 1.03–1.7]) hospitals compared to community hospitals. Conclusions Patients undergoing RC at AHV hospitals were more likely to meet quality criteria. However, performance remains low across hospital types, highlighting the opportunity to improve quality of care for MIBC.

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Section: Discussionmentioning

confidence: 99%

Variation in performance of candidate surgical quality measures for muscle‐invasive bladder cancer by hospital type

et al. 2014

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“…6,11 However, as survival after treatment for bladder disorders steadily improves and the number of patients with continent urinary diversion increases, this issue may assume greater importance. 1,20,22 Disorders of Hepatic Metabolism When intestine is used in urinary diversion, absorption of ammonia into the portal circulation increases because of the increased load of ammonia from the urine. 6,11,23 Under normal circumstance, the liver clears the increased ammonia load without significant alteration in serum ammonia levels.…”

Section: Bone Demineralizationmentioning

confidence: 99%

“…In adults, oncologic indications for removal of the bladder include both muscle invasive bladder cancer and recurrent nonmuscle invasive bladder cancer refractory to conservative treatment. 1 Children may also need radical cystectomy for malignancies, such as rhabdomyosarcoma. In addition, other nononcologic causes may occasionally result in the removal of the bladder and, consequently, a urinary diversion, such as severe neuropathic bladder, treatment refractory overactive bladder, interstitial cystitis, radiation cystitis, and tuberculosis.…”

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confidence: 99%

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We Can Rebuild It: Reconstructive Solutions for Structural Urologic Diseases

Abdullah

Lakshmanan

2015

Advances in Chronic Kidney Disease

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“…Furthermore, numerous studies, including a Cochrane review, have reported on the comparison of conduits and neobladders, with no definite unanimous superiority of one over the other [12–19]. However, these studies were on ORC with no comparison of LRC conduit and neobladders found in the literature.…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic radical cystectomy: neobladder or ileal conduit, debate still goes on

Aboumarzouk

Drewa

Olejniczak³

et al. 2014

CEJU

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ObjectiveTo compare the pre, intra, and post–operative data between ileal conduit and neobladder urinary diversions during laparoscopic radical cystectomy(LRC).Material and methodsBetween 2006 and 2011, 63 patients who underwent LRC and urinary diversion had their data input prospectively into a database and said data used for the analysis. The outcome comparators were the patient demographics, operative time, conversion rate, blood loss, transfusion rate, morphine analgesic requirement, length of hospital stay, complication rates, follow up, and quality of life assessments. A Mantel–Haenszel test was used for dichotomous data and an inverse variance method was used for continuous data. P values less than 0.5 were considered significantResultsThirty–nine patients (60 ±7.11 years) had ileal conduits and 24 patients (57 ±8.68 years) had neobladder urinary diversion. No difference was found (P >0.05) regarding age, BMI, smoking history, TURBT pathology result, blood loss, blood transfusion requirement, conversion rates, length of hospital stay, morphine requirement, complications, or follow–up and quality of life. The neobladder groups did have more previous abdominal operations and had significantly longer operative time.ConclusionsWe found no difference between either types of diversion in all comparative aspects except that the neobladder had longer operative times. This is the first comparative study between ileal conduit and neobladder urinary diversion after laparoscopic radical cystectomy and can pose as a bench mark for future comparisons.

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Urinary diversion and bladder reconstruction/replacement using intestinal segments for intractable incontinence or following cystectomy

Abstract: , S. M. (2012). Urinary diversion and bladder reconstruction/replacement using intestinal segments for intractable incontinence or following cystectomy. Cochrane Database of Systematic Reviews, (2),-. [CD003306].

Cited by 78 publications

References 42 publications

Variation in performance of candidate surgical quality measures for muscle‐invasive bladder cancer by hospital type

Variation in performance of candidate surgical quality measures for muscle‐invasive bladder cancer by hospital type

We Can Rebuild It: Reconstructive Solutions for Structural Urologic Diseases

Laparoscopic radical cystectomy: neobladder or ileal conduit, debate still goes on

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