Cascade of complications following a radical cystectomy with orthotopic bladder substitution
Author Affiliations1Novosibirsk Research Institute of Traumatology and Orthopaedics n.a. Ya.L.Tsivyan, 630090, Novosibirsk, Frunze str., 17
2Novosibirsk State Regional Hospital, 630087, Novosibirsk, Nemirovich-Danchenko str., 130
3Novosibirsk State Regional Hospital, 630087, Novosibirsk, Nemirovich-Danchenko str., 130
Abstract
At the present stage of oncourology development, radical cystectomy is considered insufficient and a need to ensure high quality of life of patient and to minimize the risk of chronic urinary infections and renal insufficiency is required. The article describes a clinical case of treatment for bladder cancer using radical cystectomy with orthotopic neobladder with the use of an excluded ileal segment according to Studer. The cascade of complications occurred postoperatively causing several corrective reoperations, including nephrectomy of the right kidney, extirpation of the neobladder, and ureterocutaneostomy. The patient recovered and was discharged on the 119th days after cystectomy. The analysis of this clinical case reveals the need for a precise surgical technique for forming the urinary reservoir, since its permeability can cause encysted extravasation of urine, which is the source of inflammatory complications. Hemorrhage into urinary tract can easily cause tamponade of the low-pressure reservoir, which requires an aggressive surgical approach, as in the case of treatment for other complications.
Key words
References
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About Authors (Correspondence):
Yarin G.Yu. – candidate of medical sciences, head of functional group of neuro-urology e-mail: metrogil@yandex.ru
Yudanov A.V. – candidate of medical sciences, head physician of coloproctology center
Bodenko O.S. – urologist
