Search

The diagnosis of bladder cancer and necessity of urostomy is profoundly life changing. This qualitative study was conducted in order to assess lived experiences of patients who had received urostomy due to bladder cancer or any other urinary pathology. The sample included 30 patients with urostomy admitted in the Urology ward, AIIMS, New Delhi. Purposive sampling was used and data was collected using semi structured interviews. Narrative data was analysed using Colaizzi’s steps of analysis for qualitative data. Ten themes emerged from the analyses which were further categorized into sub themes. The theoretical framework of the themes and subthemes defined the phenomenon of living with urostomy in entirety. [ABSTRACT FROM AUTHOR]

Radical cystectomy is the standard of care for patients with muscle invasive bladder cancer. While open radical cystectomy is now a standard procedure, laparoscopic radical cystectomy is still in its infancy. We performed this surgery laparoscopically in 11 patients and review the procedure specific complications. Beginning in February 1999, 11 patients underwent laparoscopic radical cystectomy at the Department of Urology, All India Institute of Medical Sciences, New Dehli. Urinary diversion was performed by an open-hand sewn ileal conduit. There were three intraoperative complications specifically related to the laparoscopic radical cystectomy. These included injury to the external iliac vein in one patient and a small rectal tear in two. All were repaired with laparoscopic free hand suturing with normal postoperative recovery. Other laparoscopy-related complications were subcutaneous emphysema in one patient and hypercarbia necessitating conversion to open surgery in a patient who, four weeks after surgery, died of multiple organ failure. One patient had margins positive and received cisplatinum-based chemotherapy. All patients had normal renal function and preserved upper tracts with no evidence of metastasis at a mean of 18.4 months follow up (range 1–48 months). Though there were three complications specific to the laparoscopic radical cystectomy, none necessitated a conversion to open surgery or hampered the overall outcome. Absence of local recurrence or metastatic disease at four years of follow up suggests that the procedure is oncologically valid. Laparoscopic radical cystectomy is a new procedure and it is important to critically analyze the complications in order to reduce their occurrence and allow the development of a better technique. [ABSTRACT FROM AUTHOR]