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Advances in Urology
Volume 2015, Article ID 323157, 7 pages
http://dx.doi.org/10.1155/2015/323157
Review Article

Complications of Radical Cystectomy and Orthotopic Reconstruction

1Division of Surgery and Interventional Science, UCL Medical School, University College London, 74 Huntley Street, London WC1E 6AU, UK
2Department of Urology, University College London Hospital, 16-18 Westmoreland Street, London W1B 8PH, UK

Received 31 July 2015; Revised 26 October 2015; Accepted 11 November 2015

Academic Editor: Fabio Campodonico

Copyright © 2015 Wei Shen Tan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Radical cystectomy and orthotopic reconstruction significant morbidity and mortality despite advances in minimal invasive and robotic technology. In this review, we will discuss early and late complications, as well as describe efforts to minimize morbidity and mortality, with a focus on ileal orthotopic bladder substitute (OBS). We summarise efforts to minimize morbidity and mortality including enhanced recovery as well as early and late complications seen after radical cystectomy and OBS. Centralisation of complex cancer services in the UK has led to a fall in mortality and high volume institutions have a significantly lower rate of 30-day mortality compared to low volume institutions. Enhanced recovery pathways have resulted in shorter length of hospital stay and potentially a reduction in morbidity. Early complications of radical cystectomy occur as a direct result of the surgery itself while late complications, which can occur even after 10 years after surgery, are due to urinary diversion. OBS represents the ideal urinary diversion for patients without contraindications. However, all patients with OBS should have regular long term follow-up for oncological surveillance and to identify complications should they arise.