RADICAL CYSTECTOMY WITH CAECOCYSTOPLASTY - FUNCTIONAL AND ONCOLOGIC RESULTS - AN EXPERIENCE ON 101 CASES

From 1979 to 1992, 101 radical cystectomy with caecoplasty were perfor med by the same operator (MR). Mean age of the patients was 62 years w ith a sex-ratio: 10 males / 1 female. The indications were: Transition al Cell Carcinoma in 89 cases, neurologic bladder in 5 cases, intersti tial cystitis in 3 cases tuberculosis bladder in 3 cases and lymphoma in one case. The operative mortality was 3% and postoperative morbidit y was 8%. The surgical procedure consisted of performing a neobladder with ileocaecal segment, The technique of ureterocaecal implantation c hanged during the study period. On a functionnal point of view, 28 ure terocaecal 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 taenia-myotomy of the caecum permitted to increase the uroflowmetric performance of the bladder without atonic risk. The 5 and 10 year overall actuarial surv ival rate were respectively 5% and 30%. Tumoral stage was a significan t prognostic factor. An adjuvant chemotherapy was performed in 28 pati ents. The 5 year actuarial survival rate of the patients with a chemot herapy was 82 % versus 28 % for the patients without chemotherapy (p < 0.01). Caecocystoplasty after radical cystectomy was a reliable techn ique in our experience.