Oscar Rodríguez Faba1, Mark D Tyson2, Walter Artibani3, Bernard H Bochner4, Fiona Burkhard5, Scott M Gilbert6, Tilman Kälble7, Stephan Madersbacher8, Roland Seiler9, Ella C Skinner10, George Thalmann9, Joachim Thüroff11, Peter Wiklund12, Richard Hautmann13, Joan Palou14. 1. Urological Oncology Unit, Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, C/Cartagena, 340-350, 08025, Barcelona, Spain. orodriguez@fundacio-puigvert.es. 2. Department of Urology, Mayo Clinic, Scottsdale, USA. 3. Urology Clinic, Verona Integrated University Hospital, Verona, Italy. 4. Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA. 5. Department of Urology, Inselspital Bern, Bern, Switzerland. 6. Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA. 7. Urology and Pediatric Urology Clinic, Klinikum Fulda, Fulda, Germany. 8. Urology Department, Kaiser-Franz-Josef Hospital, Vienna, Austria. 9. Uro-Oncology and Prostate Centre, Department of Urology, Inselspital Bern, Bern, Switzerland. 10. Urologic Oncology, Department of Urology, Stanford University, Stanford, USA. 11. Department of Urology, University Clinic Mannheim, Mannheim, Germany. 12. Department of Urology, Department of Molecular Medicine and Surgery, Karolinska University Hospital, Solna, Sweden. 13. Department of Urology, University of Ulm, Ulm, Germany. 14. Urological Oncology Unit, Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, C/Cartagena, 340-350, 08025, Barcelona, Spain.
Abstract
PURPOSE: To provide a comprehensive overview and update of the joint consultation of the International Consultation on Urological Diseases (ICUD) and Société Internationale d'Urologie on Bladder Cancer Urinary Diversion (UD). METHODS: A detailed analysis of the literature was conducted reporting on the different modalities of UD. For this updated publication, an exhaustive search was conducted in PubMed for recent relevant papers published between October 2013 and August 2018. Via this search, a total of 438 references were identified and 52 of them were finally eligible for analysis. An international, multidisciplinary expert committee evaluated and graded the data according to the Oxford System of Evidence-based Medicine. RESULTS: The incidence of early complications has been reported retrospectively in the range of 20-57%. Unfortunately, only a few randomized controlled studies exist within the field of UD. Consequently, almost all studies used in this report are of level 3-4 evidence including expert opinion based on "first principles" research. CONCLUSIONS: Complications rates overall following RC and UD are significant, and when strict reporting criteria are incorporated, they are much higher than previously published. Complications can occur up to 20 years after surgery, emphasizing the need for lifelong follow-up. Progress has been made to prevent complications implementing robotic surgery and fast track protocols. Preoperative patient information, patient selection, surgical techniques, and careful postoperative follow-up are the cornerstones to achieve good results.
PURPOSE: To provide a comprehensive overview and update of the joint consultation of the International Consultation on Urological Diseases (ICUD) and Société Internationale d'Urologie on Bladder Cancer Urinary Diversion (UD). METHODS: A detailed analysis of the literature was conducted reporting on the different modalities of UD. For this updated publication, an exhaustive search was conducted in PubMed for recent relevant papers published between October 2013 and August 2018. Via this search, a total of 438 references were identified and 52 of them were finally eligible for analysis. An international, multidisciplinary expert committee evaluated and graded the data according to the Oxford System of Evidence-based Medicine. RESULTS: The incidence of early complications has been reported retrospectively in the range of 20-57%. Unfortunately, only a few randomized controlled studies exist within the field of UD. Consequently, almost all studies used in this report are of level 3-4 evidence including expert opinion based on "first principles" research. CONCLUSIONS: Complications rates overall following RC and UD are significant, and when strict reporting criteria are incorporated, they are much higher than previously published. Complications can occur up to 20 years after surgery, emphasizing the need for lifelong follow-up. Progress has been made to prevent complications implementing robotic surgery and fast track protocols. Preoperative patient information, patient selection, surgical techniques, and careful postoperative follow-up are the cornerstones to achieve good results.
Entities:
Keywords:
MIBC and urinary diversions; Radical cystectomy and complications; Urinary diversion
Authors: Jeffrey J Leow; Jens Bedke; Karim Chamie; Justin W Collins; Siamak Daneshmand; Petros Grivas; Axel Heidenreich; Edward M Messing; Trevor J Royce; Alexander I Sankin; Mark P Schoenberg; William U Shipley; Arnauld Villers; Jason A Efstathiou; Joaquim Bellmunt; Arnulf Stenzl Journal: World J Urol Date: 2019-01-25 Impact factor: 4.226