Comparative analysis of colon conduit and modified ureterosygmostomy derivation methods after radical cystectomy

Results of treatment of patients with bladder cancer are presented; all patients underwent radical cystectomy with two types of urine diversion: shaping of urine conduit with appendicostoma from ileocecal angle (group 1, 30 patients) and urine diversion by forming reservoir from sigmoid colon with ureterosigmoanastomosis (group 2, 49 patients). Data received showed better survival rates in group 1 patients (hospital lethality rates 0% and 10.2% in group 1 and group 2 respectively) and significantly better rates of early and longterm postoperative complications in group 1 (early complications 13.3% and 69.4%, long-term complications 10% and 59.2% respectively). Nevertheless recurrent operation rates were about equal (13.3% and 18.4% in group1 and group 2 respectively), as far as most of complications in group 2 were managed conservatively. Functional reservoir capacity gained physiological values after 3 - 6 months after surgery with preserving low values of intrareservoir pressure. Both methods of urine diversion made possible recovering of earlier disturbed urodynamics of upper urinary tract, that improved renal function in patients with preoperative renal failure. Satisfactory social rehabilitation was achieved in patients of both groups.