Early complications after "V" shaped heterotopic ileocystoplasty

Introduction. Bladder cancer is currently an important medical and social problem due to the rapid growth of the incidence and prevalence of this malignant neoplasm on a global scale.

Radical cystectomy is the surgery of choice for the treatment of patients with muscle-invasive bladder cancer, as well as with continuously recurrent course of superficial bladder cancer.

Radical cystectomy is currently considered the most time-consuming operation in urological practice with a large number of possible complications. With the accumulation of world experience, heterotopic reconstruction of the bladder using a segment of the ileum has become the most popular method of urine derivation.

Over the past 10 years, V-shaped heterotopic ileocystoplasty has been mastered and introduced into routine practice in our center, as opposed to the classic Bricker conduit.

The purpose of the study. To compare the number of early complications in patients who underwent radical cystoprostectomy with the formation of a heterotopic reservoir according to Bricker and patients with a V-shaped heterotopic reservoir.

Materials and methods. A retrospective analysis of patients from 2 groups was carried out: control group I – patients after cystectomy with Bricker ileocystoplasty (n=72). Group II of the study – patients after cystectomy with V-shaped heterotopic ileocystoplasty (n=74).

Treatment results. There is a significant decrease in the number of adaptive pyelonephritis in the study group. The number of pyelonephritis in the group of patients with separate urine derivation is 5,4 %, the number of adaptive pyelonephritis in the control group is 20,8 % of the total number of operated patients. The number of complications III-IV according to Clavien-Dindo in the group of V-shaped ileocystoplasty is 10.8%, in the control group 18 %, as a result of which V-shaped ileocystoplasty can be recommended for daily practice.

Conclusion. Modified V-shaped heterotopic urine derivation is easily feasible. This method should be used in daily practice.

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