[Cystectomy followed by cecocystoplasty: functional and oncologic results. An experience of 101 cases]

From 1979 to 1992, 101 radical cystectomy with caecoplasty were performed by the same operator (MR). Mean age of the patients was 62 years with a sex-ratio: 10 males/1 female. The indications were: Transitional Cell Carcinoma in 89 cases, neurologic bladder in 5 cases, interstitial cystitis in 3 cases tuberculosis bladder in 3 cases and lymphoma in one case. The operative mortality was 3% and postoperative morbidity was 8%. The surgical procedure consisted of performing a neo-bladder with ileocaecal segment. The technique of ureterocaecal implantation changed during the study period. On a functional point of view, 28 ureterocaecal stenosis were reported (15%). It were rare (2.4%) with the last ureterocaecal anastomosis technique. The diurnal continence rate was 100%. The nocturnal continence rate was only 25%. On uroflowmetric point of view, the detubularization permitted to obtain low pressure bladders with 15% rate of atonic bladder. Transverse taeniamyotomy of the caecum permitted to increase the uroflowmetric performance of the bladder without atonic risk. The 5 and 10 year overall actuarial survival rate were respectively 5% and 30%. Tumoral stage was a significant prognostic factor. An adjuvant chemotherapy was performed in 28 patients. The 5 year actuarial survival rate of the patients with a chemotherapy was 82% versus 28% for the patients without chemotherapy (p < 0.01). Caecocystoplasty after radical cystectomy was a reliable technique in our experience.