Abstract

85 cases ircated by radical cystoprostatectomy or salvage cystectomy combined with modified İndiana pouch or orthotopic ileal bladder substitution of whom 16 had reccived preoperative radiotherapy are reviewed with regard to mortality and reoperations in the first 30 days of operation. The mean age of (hese patients was 63 (25-74) ileal orthotopic bladder substitution was done in 52 patients, including 3 female patients. Of the 33 patients with modified İndiana pouch 3 were female patients. 8 ofthese 85 patients diedin the first 30 postoperative days while peroperative mortality was not recorded. 4 of the 8 patients dicd due to causes that were not related to the diversion operation (2 died of myocardial infarction, one died ofseplicemia due to pneumonia and the final one dicd of cardio-pulmonary insufficiency). The remaining patients died of septicemia due to complications necessitaling reoperation. 19 ofthe $5 cases reguired eariy reoperation but only one of these didn't accept it. In cases with ileal orthotopic neobladder, carly reoperation causes were as follows; Wound dehiscence; 4 cases (7,7 9b), ileus; 2 cases ( 3.8 Yo), ileal-pouch fistula; 1 case (1,9 46), wound dehiscence andurine leakage; 2 cases (3,8 96) and evisceration and urine leakage; 3 cases (5,7 90). In cases with modified Indiana pouch, causes of the reoperalions Were wound dehiscence (1 case), evisceration andurine leakage (1 case), ileus (2 cases), postoperalive bleeding (1 case) and anuria due to bilateral ureteral obstruction (1 case). While carly mortality rate related to ileal orthotopic neobladder operations was 1,8 fo, it was 9 Ja for modified Indiana pouch operations. While 50 (4 ofthe early reoperations were related to pouch in the cases with ileal neob- ladder, 33 46 ofthe reoperations were related to pouch in the cases wilh modified Indiana pouch. Continent urinary pouch reconstruction operations are freguenily practiced following radical cystectomy. Surgical team, as well as the patients should decide (he operation in (he view of these early mortality and reoperation risks.