Radical Cystectomy With Ileal Conduit, Abroad

Radical cystectomy with ileal conduit cost:
{the cost covers all destination medical & logistics costs}
International Destinations: India, Jordan, Mexico, South Korea, Turkey

Radical cystectomy is one of the most efficient and effective ways of controlling invasive cancers of the bladder. In the United States of America, bladder cancer is one of the five most common cancers (with others being lung, prostate, breast and colon). As per available evidence, about 60,000 new cases of bladder cancer were detected in 2006, in the United States of America, and bladder cancer contributed to 12,000 deaths in the same year. A radical cystectomy procedure involves the surgical resection of the entire urinary bladder and the surrounding lymph nodes. In a male patient even the prostate is removed. After the removal of the bladder an Ileal Conduit (IC) is required to allow urinary diversion and excretion of liquid waste out of the body. Radical Cystectomy with Ileal Conduit is a standard procedure used for carcinomas affecting the urinary bladder. This procedure is available in Jordan, Turkey, India, South Korea and Mexico, at considerably lower costs.

Indications for Radical Cystectomy with ileal conduit:

It is a major surgical procedure and hence the medical condition of the patient needs to be assessed prior to undertaking the surgery,

• The surgery is recommended for most of the forms of bladder cancers ranging from flat in situ cell carcinoma to T4, a carcinoma invading the prostrate
• Squamous cell carcinoma of the bladder
• Sarcoma of the bladder (i.e. cancers affecting the connective tissue namely muscles, cartilage, bone, etc)

Survival rate after Radical Cystectomy:

The survival rates after the radical cystectomy procedure depend upon the spread of the tumor and the stage at which the surgery is conducted. Clinical studies indicate that the 5 year survival rate after radical cystectomy is about 58%. However patients with lymph node metastasis had the worst prognosis with five year survival rate of mere 30%. Unfortunately clinical evidence suggests that complementary radiotherapy or chemotherapy doesn’t alter the survival rate.

Preoperative Considerations for Radical Cystectomy with ileal conduit:

• After a thorough physical examination the patient is subjected to a battery of tests to assess the location, spread and expanse of the tumor. These tests include CT scan or an MRI of the pelvic and abdominal region.
• Once the status of the patient is confirmed, the patient’s medical status is assessed though a detailed medical history and several investigations aimed at reviewing the patient’s heart condition, lung function, liver function and basic blood count.
• The patient is counseled about the procedure and whether the procedure will require removal of other pelvic organs like prostate (in males), ovaries and fallopian tubes (in females).
• All blood thinning medications like aspirin, ibuprofen, etc are stopped at least one week prior to the surgery
• The patient is started on a low residue diet three days prior to the procedure, to reduce the volume and frequency of stools and increase the intestinal transit time.
• Low molecular weight heparin is injected intravenously a day prior to the surgery. At this time the patient is allowed only liquid diet. Laxatives or enema is given on the day prior to the surgery to clear the bowels
• The patient is given antibiotic cover on the day preceding the scheduled date of the surgery to protect him against any infections that may develop as a consequence of the surgery

Radical Cystectomy with ileal conduit: The procedure

• The operation is conducted under general anesthesia with muscle relaxants given intravenously. The procedure is a complex surgery and may take up to 3 to 4 hours
• A transverse midline incision is made below the umbilicus from where the retro peritoneal space is assessed and the bladder is dissected. The surrounding lymph nodes along with other surrounding organs are dissected as required.
• A small part of the ileum is cut and connected to the ureters (i.e. the tubes that flow urine from the kidney to the bladder) at one end. The other end of the dissected ileum is connected to the surface of the abdomen through a small opening called the ‘stoma’.
• After the procedure, urine flows from the kidneys down through the ureters into the ileal conduit and comes out through the stoma. The patient is made to wear a urostomy bag, which is a waterproof bag, which collects the urine.

Complications and post operative care of radical cystectomy with ileal conduit:

• Some degree of heamaturia (i.e. blood in urine) is expected, due to the nature of the procedure.
• Some cases may present with leakage of urine through the newly formed route. Surgical correction of such errors is inevitable
• The patient will be hospitalized for 5 to 7 days after the procedure. The patient is kept on Intravenous pain medications to alleviate pain. The diet immediately after the surgery will comprise mainly of fluids which will be progressively replaced by solids once the bowels recover.
• Other long term complications include recurrent urinary tract infections, ureteric strictures, stomal strictures, acidosis with bilateral hydronephrosis and renal stone.

Radical Cystectomy with Ileal conduit in India

India has several renowned urologists and oncosurgeons, with expertise in management of cancers of the urinary bladder and the region surrounding it. The country is home to the largest English speaking population in the world, which considerably helps the stay and health care services for medical tourists.

Radical Cystectomy with Ileal conduit in Mexico:

Mexico has its borders with the United States of America, which significantly reduces the strain of travel for medical tourists seeking medical care outside their home country. The medical and surgical care in the country is also considerably cheaper than that in the United States.

Radical Cystectomy with Ileal conduit in Turkey:

For Americans looking for good quality of medical and surgical care, at lower prices, Turkey is the best destination. Turkey has already registered substantial growth over the past few years, with medical tourists from across the world visiting this location in the Mediterranean to seek medical care.

Radical Cystectomy with Ileal conduit in Jordan:

Jordan, like most medical tourism destinations provides the advantage of cost, whilst maintaining international standards for quality care. The country is focusing on improving its physical infrastructure to make the country more acceptable by medical tourists, especially from the United States.

Radical Cystectomy with Ileal conduit in South Korea:

South Korean hospitals are abreast with the latest advances in medical science technology and are apt to cater to oncology care. The country has a directed focus on oncology (both surgical and medical cases) and provides comprehensive services to medical tourists.

Resources:

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Medical Tourism Corporation facilitates radical cystectomy with ileal conduitin Europe, India and other overseas world-class oncology treatment destinations.