China
Africa
Explore chapters and articles related to this topic
Urological cancer
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
This may be considered for progressive superficial bladder cancer and locally advanced muscle-invading tumours. It is also used to salvage recurrence after radical radiotherapy and involves removal of the bladder and perivesical tissues together with pelvic lymphadenectomy. For multifocal lesions, urethrectomy is also recommended. Urine is diverted via an ileal conduit to the abdominal wall or into a neobladder fashioned from the bowel, which can be retrained to void or be drained by intermittent self-catheterization.
Urology
Published in Gozie Offiah, Arnold Hill, RCSI Handbook of Clinical Surgery for Finals, 2019
➣ Invasive Transitional Cell Carcinoma - Curative therapy can be offered with neoadjuvant chemotherapy and radical cystectomy (Urinary diversion will be required via Urostomy/Ileal Conduit). Neobladder can be fashioned in younger patients with a good performance status - Radical radiotherapy (In patients unfit for cystectomy) is an option however side effects of radiation cystitis and proctitis are unfavourable for patients.
Management of Locally Advanced and Recurrent Rectal Cancer
Published in Peter Sagar, Andrew G. Hill, Charles H. Knowles, Stefan Post, Willem A. Bemelman, Patricia L. Roberts, Susan Galandiuk, John R.T. Monson, Michael R.B. Keighley, Norman S. Williams, Keighley & Williams’ Surgery of the Anus, Rectum and Colon, 2019
Where a cystectomy has been performed, subsequent urinary reconstruction through either an ileal or colonic conduit will be needed. The choice between ileal and colonic conduit is surgeon-dependent, although in patients with LRRC, particularly if there has been re-irradiation that perhaps the terminal ileum has been irradiated, which may predispose to urine leaks at the uretero-conduit anastomosis. A colonic conduit has the advantage of being out of the radiation field and in patients who already have an established colostomy, this has the added advantage of avoiding an additional colo-colonic anastomosis (Figure 36.12). A colonic conduit, however, is less peristaltic and may therefore predispose to urinary stasis. The use of an orthotopic neobladder is popular within the urological or gynae-oncology literature, but this is rarely offered in patients with LARC or LRRC.117
Evaluating the cost-utility of intravesical Bacillus Calmette-Guérin versus radical cystectomy in patients with high-risk non-muscle-invasive bladder cancer in the UK
Published in Journal of Medical Economics, 2023
Kristin Grabe-Heyne, Christof Henne, Isaac Odeyemi, Johannes Pöhlmann, Waqas Ahmed, Richard F. Pollock
Bladder cancer was the 12th most common cancer worldwide in 2020.1 Non-muscle-invasive bladder cancer (NMIBC) accounts for between 70–75% of bladder cancers at the time of initial diagnosis,2 and can be further classified into low-, intermediate-, high-, or very high-risk disease.3 Treatment guidelines for high-risk NMIBC recommend patients undergo transurethral resection of bladder tumor (TURBT), followed by intravesical immunotherapy with Bacillus Calmette-Guerin (BCG).3,4 BCG is a live attenuated strain of Mycobacterium bovis that is administered into the bladder using a catheter and left in the bladder for 2 h, with weekly treatments for the first 6 weeks and, ideally, subsequent maintenance therapy, and with follow-up cystoscopies for the remainder of patient lifetimes.5 As an alternative to intravesical BCG, immediate radical cystectomy (RC) may be considered.3,5,6 This surgical procedure involves the complete removal of the bladder and surrounding tissues, followed by the creation of an ileal conduit (urostomy) or (orthotopic) neobladder to allow storing and passing of urine.7
Mini-laparotomy radical cystectomy with limited bowel externalization during ileal conduit urinary diversion reduces the rate of postoperative complications: a match-paired, single centered analysis
Published in Acta Chirurgica Belgica, 2023
Dejan Djordjevic, Svetomir Dragicevic, Marko Vukovic
The limitations of our study were the small sample size and lack of randomization. Additionally, we included only patients with ileal conduit urinary diversion, since minimization of bowel manipulation is not a real issue in neobladder construction. Moreover, detailed information on perioperative ERAS protocol has been routinely included in our surgical database since 2015. Thus, the inclusion of contemporary patients resulted in a relatively small cohort size. Despite these points, we found significantly better postoperative outcomes in terms of wound infection, LOS, postoperative pain, and time to bowel restitution among patients treated with the mini-laparotomy approach and additional minimal bowel externalization. We consider this approach to be a significant finding, which could replace conventional open RC and improve patients’ early recovery after major pelvic surgery. However, larger prospective and randomized studies comparing this approach with laparoscopic or robotic RC will be necessary to estimate its true significance.
Long-term outcomes after bladder-preserving tri-modality therapy for patients with muscle-invasive bladder cancer
Published in Acta Oncologica, 2021
Emmanuelle Fabiano, Catherine Durdux, Bertrand Dufour, Arnaud Mejean, Nicolas Thiounn, Yves Chrétien, Jean-Emmanuel Bibault, Philippe Giraud, Sarah Kreps, Antoine Smulevici, Safia Maraadji, Martin Housset
Bladder cancer is the 11th most commonly diagnosed cancer worldwide. For localized muscle-invasive bladder (MIBC), treatment includes induction chemotherapy, followed by radical cystectomy [1,2]. Advances in the surgical technique and perioperative care, significantly reduced complication rates. On the other hand, orthotopic neobladder may have a positive impact on quality of life but has the potential of increasing short and long-term complication rates, compared to standard urinary diversion [3,4]. However, Hautmann’s study shows that among 923 patients (pts) having had an orthotopic neobladder, 40% had late complications [5]. More than one-third of pts develop metastasis within 3 years after surgery, particularly pts with pT3 stages. In this context, alternative conservative strategies have been developed during the last decade, following approaches similar to the anal canal or laryngeal cancer treatments.