The Discuss Of The Orthotopic Ileal Bladder And Bricker Operation Postoperative Complications

Objective: To compare the clinical effects of the orthotopic ileal bladder andbricker operation and to discusses the postoperative complications of the twooperations.Methods:. A retrospective analysis of the60patients with urothelial carcinomareceived radical cystectomy were conducted.According to different methods of theoperation,the patients were divided into two groups,one was the thotopic ileal bladdergroup,the other was the bricker operation group. The former included22cases, and thelatter included38cases. The occurrence of the blood transfusion during operation, thelength of time of the operation, hospitalization time, perioperative mortality, reoperationrate, the early complications (after3months) conditions, and late complications (after3months above) of the two surgical intraoperatie were compared.Results: Among all the patients,57cases were followed-up by the rate of95%.There was1case of the orthotopic ileal bladder group was lost to follow-up,2cases ofthe bricker operation group was lost to follow-up. All the patients were followed up for15to30months, the mean time of follow-up of the orthotopic ileal bladder group was27.5months, that of the bricker operation group was26months. There were no deathsof the two groups during the follow-up period. The two groups were comparable on age,sex, pathology classification and the clinical stages(P>0.05). The orthotopic ilealbladder group: operation time was5-6h, an average of5.2±0.4h; blood transfusionduring operation was320-630ml, an average of380±112ml; hospitalization time:30-39days, an average of35±8.4days; Perioperative mortality rate of0; the rate ofreoperation is4.5%; Early complications urination difficulties for2(9%) cases,incomplete intestinal obstruction2(9%) cases, urinary leak4(18%) cases. Long-term complications for urinary tract infection2(9%) cases, the allantoic stone1cases (4.5%)cases, ureteral obstruction of the mouth2(9%) cases. The bricker operation group:operation time is4-5h, an average of4±0.6h; blood transfusion during operation was290-500ml, an average of340±105ml; hospitalization time:19-26days, in average,24±7.2days; Perioperative mortality rate of0; the rate of reoperation is2.6%; Earlycomplications for voiding difficulties0case, incomplete intestinal obstruction4(10.5%)cases, urinary leak1(2.6%) cases). Late complications for urinary tract infections12(31%) cases, the allantoic calculus2cases (5.2%), ureteral obstruction of the mouth4(10.5%) cases. The operation time and hospitalization time of the orthotopic ilealbladder group were significantly longer than that of the bricker operation group(P <0.05), and the postoperative urinary leak rate of the orthotopic ileal bladder group wassignificantly higher than that of the bricker operation group(P <0.05); The urinary tractinfection rates of the orthotopic ileal bladder group was significantly lower than that ofthe bricker operation group (P <0.05). As far as the occurrence rate of the postoperativecomplications of the two groups,the blood transfusion during operation, perioperativemortality, the reoperation rate, incomplete intestinal obstruction, urination difficulties,lay aside allantoic stone had no statistical differences (P>0.05).Conclusions: The comparison of the orthotopic ileal bladder and brickeroperation: it is considerable of the incidence rate of the post-operative complications,but the former can obviously improve the quality of life after surgery, and it shuld bepromoted widely. Furthermore,we should strictly controlled the operation indication ofthe orthotopic ileal bladder.