ABSTRACT
Objectives: to evaluate the efficacy and outcome of continent cutanuous urinary diversion using the extramural serous lined tunnel [CCD] and compare it with the standard ileal conduit procedure [ICD] after radical cystectomy due to bladder cancer
Patients and Methods: Between 1998 and 2002, 68 patients were underwent radical cystectomy and were not candidates for orthotopic diversion. Of these patients, 24 underwent CCD as described by Abo-Enein and Ghoneim in 1995 and 44 patients underwent ICD. Outcome analysis included operative time, hospital stay, early postoperative complications, quality of life and cosmetic appearance
Results: Overall, mean age at surgery and follow up was 55, 3 years, respectively. Mean operative time was 8.3 and 6.8 hours for CCD and ICD, respectively. Sixty cm of ileum was used to fashion the CCD pouch compared to 1520 cm used in ICD. Mean capacity of the pouch was 450 in CCD. Of CCD patients, 23 were continent and only one patient had cutaneous incontinence, one had stoma1 stenosis and one had pouchoureteral reflux associated with continence. Serum creatinine, Na, K acid acid-base profile were within normal. Most of the patients had better quality of life than ICD group. Eady postoperative complications were comparable. No intraoperative or postoperative mortality was encountered
Conclusion: Continent Cutaneous diversion is technkally feasible, aapplnce free, applicable for urinary diversion with low complication rate and good quality of life with cosmetically accepted stoma for this selected group of patients. It is considered an alfemative diversion when orthotopic type is not feasible