Ileal Neobladder for Urinary Bladder Replacement in Case of Colorectal Carcinoma with Urinary Bladder Invasion

Katsuki Danno, Masao Kameyama*, Shingo Noura, Kohei Murata, Osamu Ishikawa, Osamu Maeda** and Shingi Imaoka

Department of Surgery and Urology**, Osaka Medical Center for Cancer and Cardiovascular Diseases
Department of Surgery, Bell Land General Hospital*

We have found that extensive surgery improves good mortality in patients with locally advanced colorectal carcinoma, but ureterocutaneostomy or an ileal conduit reduces the postoperative quality of life (QOL). We conducted ileal neobladder reconstruction after radical cystectomy in 3 men with locally advanced colorectal carcinomas membrane of the bladder and invaded to within 2 cm of a vesical triangle. In surgery, we arranged an ileal segment in a W-shape and incised along the antimesentric border. An ileal plate is formed as a pouch with running sutures. Ureters are anastomosed to the proximal end of the afferent tubular ileal limb. One patient required intermittent catheterization, possibly due to a large dead space in the pelvic cavity after total pelvic exentration. Although this procedure is useful only in selected patients, an ileal neobladder is a good alternative to the urinary bladder enabling patients to void via their own urethras and maintain urinary continence.

Key words
neobladder, advanced colorectal carcinoma, QOL

Reprint requests
Katsuki Danno Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases
1-3-3 Nakamichi, Higasinari-ku, Osaka 537-8511, JAPAN

Accepted
May 25, 2004

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