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SALVAGE RADICAL CYSTOPROSTATECTOMY AND ORTHOTOPIC URINARY DIVERSION FOLLOWING RADIATION FAILURE

1998; Lippincott Williams & Wilkins; Volume: 160; Issue: 1 Linguagem: Inglês

10.1016/s0022-5347(01)63018-0

1527-3792

Bernard H. Bochner, ARSENIO J. FIGUEROA, Eila C. Skinner, Gary Lieskovsky, Zbigniew Petrovich, Stuart D. Boyd, Donald G. Skinner,

Radiation Therapy and Dosimetry

No AccessJournal of UrologyClinical Urology: Original Articles1 Jul 1998SALVAGE RADICAL CYSTOPROSTATECTOMY AND ORTHOTOPIC URINARY DIVERSION FOLLOWING RADIATION FAILURE BERNARD H. BOCHNER, ARSENIO J. FIGUEROA, EILA C. SKINNER, GARY LIESKOVSKY, ZBIGNIEW PETROVICH, STUART D. BOYD, and DONALD G. SKINNER BERNARD H. BOCHNERBERNARD H. BOCHNER , ARSENIO J. FIGUEROAARSENIO J. FIGUEROA , EILA C. SKINNEREILA C. SKINNER , GARY LIESKOVSKYGARY LIESKOVSKY , ZBIGNIEW PETROVICHZBIGNIEW PETROVICH , STUART D. BOYDSTUART D. BOYD , and DONALD G. SKINNERDONALD G. SKINNER View All Author Informationhttps://doi.org/10.1016/S0022-5347(01)63018-0AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Salvage surgery followed by lower urinary tract reconstruction is a viable therapeutic option for patients in whom definitive radiation therapy for localized bladder or prostate cancer has failed. Improvements in surgical technique and postoperative care have significantly improved overall outcome. An enhanced understanding of the rhabdoid sphincteric mechanism responsible for maintaining urinary continence following cystoprostatectomy has helped make the orthotopic neobladder the procedure of choice for patients requiring lower urinary tract reconstruction. We describe our experience with salvage surgery and orthotopic bladder substitution following failed radical radiation therapy. Materials and Methods: We evaluated the complications of 18 patients in whom definitive radiation therapy (total minimum dose 60 Gy. or greater) for bladder or prostate cancer had failed. All patients underwent a salvage procedure with creation of an orthotopic neobladder. Results: Operative characteristics, postoperative outcomes and postoperative complications related or unrelated to urinary reconstruction were similar between irradiated and nonirradiated patients. Good day and night continence following surgery was reported by 67 and 56% of irradiated patients, respectively. Patients with poor postoperative continence were successfully treated with the placement of an artificial urinary sphincter. Conclusions: Salvage surgery with orthotopic urinary reconstruction is a safe, effective procedure that provides a functional lower urinary tract in patients in whom definitive pelvic radiation therapy has failed. References 1 : T3 bladder cancer-the case for salvage cystectomy.. Brit. J. Urol.1980; 52: 506. Google Scholar 2 : The role of partial cystectomy in the treatment of recurrent invasive bladder cancer following radiotherapy.. Brit. J. Urol.1987; 60: 132. Google Scholar 3 : Bladder cancer: results of radiation therapy in 384 patients.. Radiology1975; 117: 149. Google Scholar 4 : The management of deeply infiltrating (T3) bladder carcinoma: controlled trial of radical radiotherapy versus radical cystectomy (first report).. Brit. J. 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Link, Google Scholar Departments of Urology and Radiation Oncology, Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California© 1998 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited byPieretti A, Krasnow R, Drumm M, Gusev A, Dahl D, McGovern F, Blute M, Shipley W, Efstathiou J, Feldman A and Wszolek M (2021) Complications and Outcomes of Salvage Cystectomy after Trimodality TherapyJournal of Urology, VOL. 206, NO. 1, (29-36), Online publication date: 1-Jul-2021.Eswara J, Efstathiou J, Heney N, Paly J, Kaufman D, McDougal W, McGovern F and Shipley W (2011) Complications and Long-Term Results of Salvage Cystectomy After Failed Bladder Sparing Therapy for Muscle Invasive Bladder CancerJournal of Urology, VOL. 187, NO. 2, (463-468), Online publication date: 1-Feb-2012.Eisenberg M, Dorin R, Bartsch G, Cai J, Miranda G and Skinner E (2010) Early Complications of Cystectomy After High Dose Pelvic RadiationJournal of Urology, VOL. 184, NO. 6, (2264-2269), Online publication date: 1-Dec-2010.Bochner B, Karanikolas N, Barakat R, Wong D and Chi D (2009) Ureteroileocecal Appendicostomy Based Urinary Reservoir in Irradiated and Nonirradiated PatientsJournal of Urology, VOL. 182, NO. 5, (2376-2381), Online publication date: 1-Nov-2009.TOUMA N, IZAWA J and CHIN J (2018) CURRENT STATUS OF LOCAL SALVAGE THERAPIES FOLLOWING RADIATION FAILURE FOR PROSTATE CANCERJournal of Urology, VOL. 173, NO. 2, (373-379), Online publication date: 1-Feb-2005.LEE C, HAFEZ K, SHEFFIELD J, JOSHI D and MONTIE J (2018) ORTHOTOPIC BLADDER SUBSTITUTION IN WOMEN: NONTRADITIONAL APPLICATIONSJournal of Urology, VOL. 171, NO. 4, (1585-1588), Online publication date: 1-Apr-2004.WAMMACK R, WRICKE C and HOHENFELLNER R (2018) Long-Term Results of Ileocecal Continent Urinary Diversion in Patients Treated With and Without Previous Pelvic IrradiationJournal of Urology, VOL. 167, NO. 5, (2058-2062), Online publication date: 1-May-2002. Volume 160Issue 1July 1998Page: 29-33 Advertisement Copyright & Permissions© 1998 by American Urological Association, Inc.MetricsAuthor Information BERNARD H. BOCHNER Supported by a Career Development Award from the American Cancer Society and a Research Scholarship from the American Foundation for Urologic Disease. More articles by this author ARSENIO J. FIGUEROA More articles by this author EILA C. SKINNER More articles by this author GARY LIESKOVSKY More articles by this author ZBIGNIEW PETROVICH More articles by this author STUART D. BOYD More articles by this author DONALD G. SKINNER More articles by this author Expand All Advertisement PDF downloadLoading ...