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Volume 4, Issue 1, June 2020, Page: 17-20
Oncological Outcomes and Morbidity of Radical Cystectomy for Bladder Cancer: Experience of a Senegalese Centre
Aboubacar Traore, Urology-Andrology Department, De la Paix Hospital, Ziguinchor, Senegal
Cyrille Ze Ondo, Urology-Andrology Department, Aristide Le-Dantec Hospital, Dakar, Senegal
Alioune Sarr, Urology-Andrology Department, Aristide Le-Dantec Hospital, Dakar, Senegal
Babacar Sine, Urology-Andrology Department, Aristide Le-Dantec Hospital, Dakar, Senegal
Modou Ndiaye, Urology-Andrology Department, Aristide Le-Dantec Hospital, Dakar, Senegal
Abdoulaye Ndiath, Urology-Andrology Department, Aristide Le-Dantec Hospital, Dakar, Senegal
Yaya Sow, Urology-Andrology Department, Regional Hospital, Saint Louis, Senegal
Boubacar Fall, Urology-Andrology Department, De la Paix Hospital, Ziguinchor, Senegal
Babacar Diao, Urology-Andrology Department, Aristide Le-Dantec Hospital, Dakar, Senegal
Pape Ameth Fall, Urology-Andrology Department, Aristide Le-Dantec Hospital, Dakar, Senegal
Alain Khassim Ndoye, Urology-Andrology Department, Aristide Le-Dantec Hospital, Dakar, Senegal
Mamadou Ba, Urology-Andrology Department, Aristide Le-Dantec Hospital, Dakar, Senegal
Received: Feb. 5, 2020;       Accepted: Feb. 28, 2020;       Published: Mar. 10, 2020
DOI: 10.11648/j.ijcu.20200401.14      View  159      Downloads  40
Abstract
The purpose of this paperwork is to assess the oncological findings and the morbidity rate after complete cystectomy in our department. Patients and methods: We conducted a backward and descriptive study during a 80-month-period range from September 2011 to May 2018, in the Urology Department of Aristide Le Dantec Teaching Hospital standing as a referral structure in our country (Senegal). Results: Nineteen patients were included accounting for 13 men and 6 women corresponding to a sex ratio of 2. The mean age was at 58 years old (extremes range from 32 to 77 years old). Radical cystectomy consisted of an anterior pelvectomy and transileal cutaneous ureterostomy by Bricker approach in 6 women, a radical cystoprostatectomy with transileal cutaneous ureterostomy by Bricker approach in 12 men and a radical cystoprostatectomy followed by Studer orthotopic neobladder in 1 patient. Early post-operative morbidity consisted of one case of parietal suppuration (grade I), two cases of evisceration (grade IIIb), one case of digestive fistula (grade IIIb), and uroperitoneal peritonitis (grade IIIb) secondary to suture loosening of the uretero-ileal anastomosis (which occurred in the patient who had Studer neobladder). This patient died in resuscitation ward after surgical repair of the uretero-iliary anastomosis. Late complications were a case of acute pyelonephritis three months after cystectomy and a case of flanged occlusion. Two patients with urothelial carcinoma had received adjuvant chemotherapy using the M-VAC protocol. After an average follow-up of 15 months we recorded 13 deaths, three patients were lost of sight and three others respectively lived 4 years and 2 months, 5years and 8 months and 6years and 8 months after radical cystectomy. Mean overall survival was 15 months (4.2 to 25.8 months) with a median survival of 6 months. The only patient who had Studer neobladder died one week after cystectomy. The mean overall survival after previous pelvectomy was 17.2 months and that after cystoprostatectomy was 15.18 months. Conclusion: This work highlights the very poor prognosis of bladder cancers in our context linked to the advanced stage of tumours at the time of diagnosis, the rarity of endoscopic equipment essential for the diagnosis, treatment and monitoring of bladder cancers, the frequency of radiochemically resistant squamous cell carcinoma, the unavailability of chemotherapy in urothelial carcinoma to enable multimodal treatment, and the heaviness and complexity of radical cystectomy.
Keywords
Bladder Cancer, Cystectomy, Morbidity, Oncological Outcomes
To cite this article
Aboubacar Traore, Cyrille Ze Ondo, Alioune Sarr, Babacar Sine, Modou Ndiaye, Abdoulaye Ndiath, Yaya Sow, Boubacar Fall, Babacar Diao, Pape Ameth Fall, Alain Khassim Ndoye, Mamadou Ba, Oncological Outcomes and Morbidity of Radical Cystectomy for Bladder Cancer: Experience of a Senegalese Centre, International Journal of Clinical Urology. Vol. 4, No. 1, 2020, pp. 17-20. doi: 10.11648/j.ijcu.20200401.14
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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