Functional evaluation of a modified Studer ileal neobladder

摘要

Objectives To evaluate the results of using a shorter ileal segment (40 cm only) in reconstructing Studer ileal neobladder after radical cystectomy. Subjects and methods Radical cystectomy and modified Studer ileal neobladder was performed in 60 patients for invasive bladder cancer. Only 40 cm of the ileum was used; 32 cm segment for constructing the body of the neobladder, while the remaining 8 cm as an isoperistaltic intact limb for ureteral reimplantation. After one year, evaluation included clinical, laboratory, radiographic and urodynamic studies to determine the functional and oncological outcomes. Results Early complications occurred in 5 patients (8.6%). According to the modified Clavien system, two patients had grade I complications, IIIb occurred in one patient and two patients had grade V complications. Late complications (8.6%) included incisional hernia in 2 patients, deep venous thrombosis, bilateral uretero-ileal anastomotic stricture and intestinal obstruction each occurred in one patient. At one year, daytime and nighttime continence was 93.1% and 89.7%, respectively. Reflux was observed in 6 patients (10.3%) which was unilateral in 3 patients and bilateral in 3 without affecting the renal functions. Neobladder pressure was 7–18 cmH 2 O at half capacity and 13–38 cmH 2 O at full capacity with no uninhibited contractions. Conclusion Minimizing the length of the ileum for Studer neobladder reconstruction is feasible and with acceptable results.