Long-term outcomes of sigmoid neobladder after radical cystectomy in Indian population: a single centre experience

Authors

  • Sabyasachi Panda Department of Urology, SCB Medical College, Cuttack, Odisha, India
  • Gyan Prakash Singh Department of Urology, SCB Medical College, Cuttack, Odisha, India
  • Srikant Kumar Pathi Department of Urology, SCB Medical College, Cuttack, Odisha, India

DOI:

https://doi.org/10.18203/2349-2902.isj20205872

Keywords:

Overall survival, Radical cystectomy, Sigmoid neobladder

Abstract

Background: Radical cystectomy with orthotopic neobladder is the standard of care for MIBC. Long-term data on sigmoid neobladder is limited. Sigmoid neobladder offers the advantage of low long-term metabolic and nutritional complications, due to sparing of ileum and ileo-caecal valve. We present our experience and long-term results of orthotopic sigmoid neobladder reconstruction after radical cystectomy.

Methods: The study included 57 male patients who underwent radical cystectomy and orthotopic sigmoid neobladder for muscle-invasive carcinoma of bladder from January 2002 to December 2019. Data was collected with regards to complication rate, voiding patterns, continence status, recurrence-free and overall survival.

Results: Mean age was 52.7 years (range 35 to 74). Median duration of follow-up was 62 months. There were 3 (5.3%) perioperative deaths. 15 patients (26.3%) developed early and 5 patients (8.7%) developed delayed complications. Node positive disease (N+) was found in 11 (19.3%) patients and 17 (29.8%) required adjuvant chemotherapy. 94.7% patients were continent and 42 (82.4%) patients had spontaneous voiding pattern. Daytime and nocturnal incontinence rate were 5.3% and 24.6%, respectively. Clean intermittent catheterization (CIC) was required in 8 (14.1%) cases. The recurrence-free survival (RFS) and overall survival (OS) were 57% and 50% at 5 years and 62.5% and 35.8% at 10 years, respectively.

Conclusions: Sigmoid neobladder remains a viable form of orthotopic urinary diversion and provides satisfactory long-term continence and voiding results with acceptable rate of complications. Good long-term results in sigmoid neobladder in Indian population may be due to long sigmoid colons in Indian patients with low incidence of diverticulosis.

 

Author Biographies

Sabyasachi Panda, Department of Urology, SCB Medical College, Cuttack, Odisha, India

Department of Urology,SCB Medical College, Cuttack

Assistant Professor

Gyan Prakash Singh, Department of Urology, SCB Medical College, Cuttack, Odisha, India

Department of Urology,SCB Medical College, Cuttack

Associate Professor

Srikant Kumar Pathi, Department of Urology, SCB Medical College, Cuttack, Odisha, India

Department of Urology,SCB Medical College, Cuttack

Senior Resident

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Published

2020-12-28

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Original Research Articles