[Radical cystectomy: therapeutic aspects of preoperative and early postoperative management].

AIM: to improve the results of radical cystectomy by optimization of patient preparation for surgery and early postoperative care. MATERIALS AND METHODS: A total of 136 patients who underwent radical cystectomy and either orthotopic ileal neobladder or ileal conduit formation were included in the study. Brikkers operation was performed in 92 patients (76% men and 24% women) aged from 39 to 83 years, while in 44 patients (97.7% men, 2.3% women) aged from 32 to 75 years the Studer ileal neobladder was created. All patients underwent preoperative comprehensive examinations in order to determine type and extent of surgical treatment. RESULTS: A complication rate after radical cystectomy with urine derivation using bowel segment was 49.2%. Mortality rate in early postoperative period was 3.9%. CONCLUSION: An algorithm of postoperative care after radical cystectomy with formation of either orthotopic neobladder or ileal conduit and consideration of comorbid status and preparation which we have used in clinical practice was developed. According to the results, after implementation of algorithm of management in preoperative and early postoperative period a decrease in complications and mortality rate has been found.

[Current trends in the method used for urine derivation after radical cystectomy for muscle-invasive bladder cancer].

Bladder cancer ranks 7th in the world among all malignant tumors in men and 11th in both sexes. Radical cystectomy is the gold standard of muscle-invasive bladder cancer treatment in most countries of the world. A large number of fundamentally different options for urine derivation is developed. Therefore the choice of the method of urine derivation is one of the most important and difficult in the treatment of such patients. This review covers current international articles on this topic for 2015-2018.