RADICAL CYSTECTOMY: THERAPEUTIC ASPECTS OF PREOPERATIVE AND EARLY POSTOPERATIVE MANAGEMENT


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Abstract

Aim: to improve the results of radical cystectomy by optimization of patient preparation for surgery and early postoperative care. Materials and methods. A total of 136 patients who underwent radical cystectomy and either orthotopic ileal neobladder or ileal conduit formation were included in the study. Brikker’s operation was performed in 92 patients (76% men and 24% women) aged from 39 to 83 years, while in 44 patients (97.7% men, 2.3% women) aged from 32 to 75 years the Studer ileal neobladder was created. All patients underwent preoperative comprehensive examinations in order to determine type and extent of surgical treatment. Results: A complication rate after radical cystectomy with urine derivation using bowel segment was 49.2%. Mortality rate in early postoperative period was 3.9%. Conclusion: An algorithm of postoperative care after radical cystectomy with formation of either orthotopic neobladder or ileal conduit and consideration of comorbid status and preparation which we have used in clinical practice was developed. According to the results, after implementation of algorithm of management in preoperative and early postoperative period a decrease in complications and mortality rate has been found.

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About the authors

S. P Darenkov

FGBU “Central state medical academy” of Administrative Directorate of the President of Russian Federation

MD, Head of the Department of Urology Moscow, Russia

I. S Pinchuk

FGBU “Central state medical academy” of Administrative Directorate of the President of Russian Federation

Email: doktor2000@inbox.ru
Ph.D., associate professor at the Department of Urology Moscow, Russia

A. A Proskokov

FGBU “Central state medical academy” of Administrative Directorate of the President of Russian Federation

Ph.D., associate professor at the Department of Urology Moscow, Russia

A. D Trofimchuk

FGBU “Central state medical academy” of Administrative Directorate of the President of Russian Federation

resident at the Department of Urology Moscow, Russia

Yu. N Fedulaev

FGBOU VO N.I. Pirogov Russian National Research Medical University of Minzdrav of Russia

MD, Head of the Department of the Faculty Therapy Moscow, Russia

T. V Pinchuk

FGBOU VO N.I. Pirogov Russian National Research Medical University of Minzdrav of Russia

Ph.D., associate professor at the Department of the Faculty Therapy Moscow, Russia

I. V Makarova

FGBOU VO N.I. Pirogov Russian National Research Medical University of Minzdrav of Russia

assistant at the Department of the Faculty Therapy Moscow, Russia

O. N Andreeva

FGBOU VO N.I. Pirogov Russian National Research Medical University of Minzdrav of Russia

Ph.D., associate professor at the Department of the Faculty Therapy Moscow, Russia

References

  1. Чучалин А.Г. Клинические рекомендации. Пульмонология. М.: ГЭОТАР-Медиа, 2007.
  2. Шестопалова И.М., Лактионова Л.В. Терапевтическая подготовка пациентов к оперативному лечению в онкохирургии. Клиническая практика 2013;3:73-79.
  3. Clyde W. Yarny et al. 2013 ACCF/AHA Guideline for the Management of Heart Failure: Exeortive Summary. Journal of the Amer^an College of Cardiology. 2013(62);6:1497-1536. http://dx.doi.org/10.1016/j. jacc.2013.05.020
  4. Коган М.И. Онкологические и функциональные результаты ортотопической кишечной цистопластики после радикальной цистэктомии по поводу рака мочевого пузыря. Медицинский вестник Юга России. 2012;3:38-43.
  5. Лыков А.В., Анализ ранних осложнений после радикальной цистэктомии при раке мочевого пузыря. Медицинский вестник Башкортостана. 2013;2(8):202-204.
  6. Магер В.О. Ранние послеоперационные осложнения после радикальной цистэктомии. Онкоурология. 2011;3:85-89).
  7. Чиссов, В.И. Состояние онкологической помощи населению России в 2010 году. Изд-во ФГУ «МНИOИ им. П.А. Герцена Росмедгехнологий» Минздравсоцразвития России. 2011. C. 188.
  8. Rodgers A., Walker N., Sckug S.,McKee A., Kehlet H. Redudion of postoperative mortality and morbidity with epidural or spinal anaesthesia: results from overview of randomised trials. BMJ. 2000; 321: 1-12.
  9. Ckeatkam M.L., Ckapman W.C., Key S.P. et al. A meta-analysis of selective versus routine nasogastrik: decompression after elective laparotomy. Ann. Surg. 1995;221: 469-476.
  10. Brownlee I.A., Havler M.E., Dettmar P.W. et al. Colons mudrs: sedetion and turnover in relation to dietary fibre intake. Ргос. Nutr. Sod, 2003; 62:245-249.
  11. Douglas W. Wilmore, Henrik Kehlet Management of patients in fast track surgery. BMJ. 2001;322: 473-476.
  12. Hafner C.D., Wylie J.H., Brush B.E. Completions of gastrointestinal intubation. Arch. Surg. 1961;83:163-176.

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