[Partial cystectomy for bladder carcinoma: lyophilized human dura as a bladder wall substitute]

Ten cases were treated by partial cystectomy for bladder carcinoma (anterior wall 5 cases, dome 1 case, dome to anterior wall 2 cases, lateral wall 2 cases) and these defects were covered with lyophilized human dura (LHD). A few minutes before use, LHD was put into saline for rehydration and, for anastomosis, we used 2 zero plain catgut. In eight cases cardiovascular complications, DM and liver cirrhosis were found before operation. The mean operation time +/- SD was 109 +/- 26 minutes, and the indwelling catheter was left in place for 15 to 42 days. In three cases, prolonged urine leak from the wound continued after operation, and in one case temporal VUR was found without clinical significance. No severe urinary tract infection was found in all cases. The inner surface of dura was almost epithelialized after 8 weeks, 8 cases were in good clinical condition but one case was treated by TUR for recurrence of bladder tumor 1 year and 3 months after operation. Our results with LHD as a substitute for the bladder wall have been satisfactory. The main advantage of this technique is that large vesical segmental resection is possible to such an extent as to satisfy Prout's criteria (at least 3 cm of apparently normal bladder are available to be excised around the tumor).