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KMID : 0604620020090020046
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Dongguk Journal of Medicine
2002 Volume.9 No. 2 p.46 ~ p.60
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Hautmann and Studer orthotopic neobladders
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Lee Kyung-Seop
Monitie, Jamems E.
Dunn, Rodney L.
Lee, Cheryl T.
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Abstract
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Objectives: The development of Studer and Hautmann orthotopic neobladders has revolutionized the management of urinary diversion. Several series have promoted one technique over the other This study examines the clinical outcome of a contemporary cohort of bladder cancer patients who underwent either Hautmann or Studer orthotopic reconstruction.
Materials and Methods: Retrospective analysis was performed on 130 patients (93 Studer and 37 Hautmann) who underwent cystectomy and orthotopic diversion between 1st march. 1995 and 30th September 2000. Clinical parameters evaluated were age, gender, procedure time, length of hospital stay, blood loss, pathologic stage, and rate of complication, continence, and reoperation. Diversion type was compared with clinical parameters using the Fishers exact Test, t-test, and Wilcoxon rank-sum analysis.
Results: Studer and Hautmann techniques had mean procedure times of 5.9 and 5.3 hours, respectively (p=0.003) , Hautmann patients also had a shorter mean length of hospital stay (LOS) (7.0 vs 8.3 days, respectively: p=0.02). When comparing both populations, there was no difference in age. gender, estimated blood loss (EBL), pathologic stage, or rate of complication or reoperation. Total continence was similar in the Hautmann and Studer cohorts, whether during daytime (67% vs 67%) or nighttime (47% vs 40%) hours, respectively.
Conclusions: The data suggests that both orthotopic techniques can be performed in men and women in a safe and timely fashion. Continence rates appear better with the Hautmann technique, though the limited cohort size did not offer sufficient power to detect a statistical difference. The shortened procedure time in Hautmann patients likely relates to variations in the ureteral anastomosis. Decreased LOS may reflect recent trends of early patient discharge.
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KEYWORD
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Bladder neoplasm, Neobladder, Hautmann, Studer, Hautmann, Studer
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