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Faba OR, Tyson MD, Artibani W, Bochner BH, Burkhard F, Gilbert SM, Kälble T, Madersbacher S, Seiler R, Skinner EC, Thalmann G, Thüroff J, Wiklund P, Hautmann R, Palou J. Update of the ICUD-SIU International Consultation on Bladder Cancer 2018: urinary diversion. World J Urol 2018; 37:85-93. [PMID: 30238399 DOI: 10.1007/s00345-018-2484-3] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 09/10/2018] [Indexed: 02/02/2023] Open
Abstract
PURPOSE To provide a comprehensive overview and update of the joint consultation of the International Consultation on Urological Diseases (ICUD) and Société Internationale d'Urologie on Bladder Cancer Urinary Diversion (UD). METHODS A detailed analysis of the literature was conducted reporting on the different modalities of UD. For this updated publication, an exhaustive search was conducted in PubMed for recent relevant papers published between October 2013 and August 2018. Via this search, a total of 438 references were identified and 52 of them were finally eligible for analysis. An international, multidisciplinary expert committee evaluated and graded the data according to the Oxford System of Evidence-based Medicine. RESULTS The incidence of early complications has been reported retrospectively in the range of 20-57%. Unfortunately, only a few randomized controlled studies exist within the field of UD. Consequently, almost all studies used in this report are of level 3-4 evidence including expert opinion based on "first principles" research. CONCLUSIONS Complications rates overall following RC and UD are significant, and when strict reporting criteria are incorporated, they are much higher than previously published. Complications can occur up to 20 years after surgery, emphasizing the need for lifelong follow-up. Progress has been made to prevent complications implementing robotic surgery and fast track protocols. Preoperative patient information, patient selection, surgical techniques, and careful postoperative follow-up are the cornerstones to achieve good results.
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Affiliation(s)
- Oscar Rodríguez Faba
- Urological Oncology Unit, Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, C/Cartagena, 340-350, 08025, Barcelona, Spain.
| | - Mark D Tyson
- Department of Urology, Mayo Clinic, Scottsdale, USA
| | - Walter Artibani
- Urology Clinic, Verona Integrated University Hospital, Verona, Italy
| | - Bernard H Bochner
- Urology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, USA
| | - Fiona Burkhard
- Department of Urology, Inselspital Bern, Bern, Switzerland
| | - Scott M Gilbert
- Department of Genitourinary Oncology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, USA
| | - Tilman Kälble
- Urology and Pediatric Urology Clinic, Klinikum Fulda, Fulda, Germany
| | | | - Roland Seiler
- Uro-Oncology and Prostate Centre, Department of Urology, Inselspital Bern, Bern, Switzerland
| | - Ella C Skinner
- Urologic Oncology, Department of Urology, Stanford University, Stanford, USA
| | - George Thalmann
- Uro-Oncology and Prostate Centre, Department of Urology, Inselspital Bern, Bern, Switzerland
| | - Joachim Thüroff
- Department of Urology, University Clinic Mannheim, Mannheim, Germany
| | - Peter Wiklund
- Department of Urology, Department of Molecular Medicine and Surgery, Karolinska University Hospital, Solna, Sweden
| | | | - Joan Palou
- Urological Oncology Unit, Department of Urology, Fundació Puigvert, Universitat Autònoma de Barcelona, C/Cartagena, 340-350, 08025, Barcelona, Spain
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