Abstract
Purpose: When a curative resection involving total cystectomy is performed in patients with colorectal cancer having complications of advanced bladder invasion, it is common to perform an ileal conduit as a way of reconstructing the urinary tract. However, this urostomy sometimes impairs the quality of life (QOL) and damages the patient’s body image. Recently, the urology department of our hospital has been actively implementing the modified Hautmann orthotopic ileal neobladder reconstruction after total cystectomy for bladder cancer. Therefore, we selectively adopted this procedure for the treatment of patients with colorectal cancer with a complication of bladder invasion. Method: Between January 2009 and December 2011, we encountered 5 cases of this procedure. The safety of this procedure and postoperative outcomes were assessed in these cases. Results: The average follow-up time was 29 months. The average operative time was 635 minutes, the mean blood loss was 999 g, and blood transfusion was required in 2 cases. The average hospital stay after the operation was 33.4 days, and 2 patients had postoperative urinary tract infection, 1 patient had MRSA (methicillin-resistant Staphylococcus aureus) enteritis, and 1 patient had ileus, but no other serious complications were observed. Four patients were completely able to urinate by themselves in an upright position. In only 1 case, solitary resectable lung recurrence was observed, but all patients are alive. Conclusion: Although a lengthy operation is required, this urinary tract reconstruction procedure is believed to be a safe reconstruction method that results in few post-surgical complications. It may result in a more favorable body image for the patient, but the assessment of long-term outcome, prognosis and QOL remains unknown.
