CASE REPORT article
Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1635458
Case report: Innovative surgical management of ileal neobladder fistula after radical cystectomy
Provisionally accepted- Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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An ileal neobladder fistula is a rare but serious complication of radical cystectomy with orthotopic neobladder reconstruction. Owing to its low incidence, the challenges posed by dense adhesions, and the risk to urinary function, there is little consensus on optimal management. A 68-year-old male with low-grade non-muscle-invasive bladder cancer underwent transurethral resection, followed by radical cystectomy and total laparoscopic orthotopic neobladder reconstruction. One month after surgery, the patient developed fecaluria. Imaging revealed a fistula between the neobladder and the ileum. Proximal ileostomy was performed to eliminate fecaluria. Seven months later, an open surgical repair was performed. Severe adhesions around the original ileal anastomosis and neobladder apex precluded safe separation. Rather than risking neobladder injury and loss of capacity, the surgical team preserved approximately 2 cm of the adherent ileum and restored intestinal continuity using overlap anastomosis. Postoperative recovery was uneventful, and follow-up revealed no recurrence of the fistula. This case demonstrates that the rapid identification and staged management of ileal neobladder fistulas can ensure favourable outcomes. The innovative surgical approach described here is effective in preserving both neobladder function and intestinal integrity and provides a viable, less invasive alternative for patients presenting with complex adhesions.
Keywords: Bladder cancer, Cystectomy, Fistula, preoperative diagnose, Urinary Diversion
Received: 26 May 2025; Accepted: 29 Sep 2025.
Copyright: © 2025 Ma, Ji, Rui and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Wenbin Rui, ruiwb@hotmail.com
Xiaojing Wang, ruijinwxj@163.com
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