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Hautmann and Studer Orthotopic Neobladders: A Contemporary Experience

2003; Lippincott Williams & Wilkins; Volume: 169; Issue: 6 Linguagem: Inglês

10.1097/01.ju.0000063941.31687.26

1527-3792

Kyung Seop Lee, James E. Montie, Rodney L. Dunn, Cheryl T. Lee,

Urological Disorders and Treatments

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jun 2003Hautmann and Studer Orthotopic Neobladders: A Contemporary Experience KYUNG SEOP LEE, JAMES E. MONTIE, RODNEY L. DUNN, and CHERYL T. LEE KYUNG SEOP LEEKYUNG SEOP LEE More articles by this author , JAMES E. MONTIEJAMES E. MONTIE Financial interest and/or other relationship with Astra Zeneca and UroCor. More articles by this author , RODNEY L. DUNNRODNEY L. DUNN More articles by this author , and CHERYL T. LEECHERYL T. LEE Financial interest and/or other relationship with Merck. More articles by this author View All Author Informationhttps://doi.org/10.1097/01.ju.0000063941.31687.26AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: The development of Studer and Hautmann orthotopic neobladders has revolutionized the management of urinary diversion. Several series have promoted 1 technique over the other. We examine the clinical outcome of a contemporary cohort of patients with bladder cancer who underwent either Hautmann or Studer orthotopic reconstruction. Materials and Methods: Retrospective analysis was performed on 130 patients who underwent cystectomy and orthotopic diversion (Studer 93 and Hautmann 37) between March 1, 1995 and September 30, 2000. Clinical parameters evaluated were age, gender, procedure time, length of hospital stay, blood loss, pathological stage, and rates of complication, continence and reoperation. Diversion type was compared with clinical parameters using Fisher’s exact test, t-test and Wilcoxon rank sum analysis. Results: Studer and Hautmann techniques had mean procedure times of 5.9 and 5.3 hours, respectively (p = 0.003), and mean length of stay was shorter for Hautmann than Studer (7.0 versus 8.3 days, respectively, p = 0.02). When comparing both populations there was no difference in age, gender, estimated blood loss, pathological stage or rates of complication and reoperation. Total continence was similar in the Hautmann and Studer cohorts, whether during the day (67% versus 67%) or at night (47% versus 40%), respectively. Conclusions: The data suggest that both orthotopic techniques can be performed in men and women in a safe and timely fashion. Nighttime continence rates are slightly higher with the Hautmann technique, although not statistically different. The shortened Hautmann procedure time likely relates to variations in the ureteral anastomosis. Decreased length of stay may reflect recent trends of early hospital discharge. References 1 : Cancer statistics, 2002. CA Cancer J Clin2002; 52: 23. Google Scholar 2 : The current status of bladder preservation in the treatment of muscle invasive bladder cancer. J Urol2000; 164: 627. Link, Google Scholar 3 : Continent urinary diversion. In: . 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Google Scholar From the Department of Urology, Dongguk University Hospital, Kyongju, Korea, and the Departments of Urology, Epidemiology and Biostatistics, University of Michigan, Ann Arbor, Michigan© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byClifford T, Shah S, Bazargani S, Miranda G, Cai J, Wayne K, Djaladat H, Schuckman A and Daneshmand S (2018) Prospective Evaluation of Continence Following Radical Cystectomy and Orthotopic Urinary Diversion Using a Validated QuestionnaireJournal of Urology, VOL. 196, NO. 6, (1685-1691), Online publication date: 1-Dec-2016. (2018) Reply by AuthorsJournal of Urology, VOL. 196, NO. 6, (1691-1691), Online publication date: 1-Dec-2016.Tal R, Sivan B, Kedar D and Baniel J (2018) Management of Benign Ureteral Strictures Following Radical Cystectomy and Urinary Diversion for Bladder CancerJournal of Urology, VOL. 178, NO. 2, (538-542), Online publication date: 1-Aug-2007.Song C, Kang T, Hong J, Kim C and Ahn H (2018) Changes in the Upper Urinary Tract After Radical Cystectomy and Urinary Diversion: A Comparison of Antirefluxing and Refluxing Orthotopic Bladder Substitutes and the Ileal ConduitJournal of Urology, VOL. 175, NO. 1, (185-189), Online publication date: 1-Jan-2006. Volume 169Issue 6June 2003Page: 2188-2191 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordsurinary diversionbladder neoplasmsurinary reservoirs, continentMetricsAuthor Information KYUNG SEOP LEE More articles by this author JAMES E. MONTIE Financial interest and/or other relationship with Astra Zeneca and UroCor. More articles by this author RODNEY L. DUNN More articles by this author CHERYL T. LEE Financial interest and/or other relationship with Merck. More articles by this author Expand All Advertisement PDF downloadLoading ...