Detour technique, Dipping technique, or IIeal bladder flap technique for surgical correction of uretero-ileal anastomotic stricture in orthotopic ileal neobladder
Int. braz. j. urol
;
41(4): 796-803, July-Aug. 2015. graf
Article
in English
| LILACS
| ID: lil-763063
ABSTRACT
ABSTRACTBackground:
Uretero-ileal anastomotic stricture (UIAS) is a urological complication after ileal neobladder, the initial management being endourological intervention. If this fails or stricture recurs, surgical intervention will be indicated.Design andParticipants:
From 1994 to 2013, 129 patients were treated for UIAS after unsuccessful endourological intervention. Unilateral UIAS was present in 101 patients, and bilateral in 28 patients; total procedures were 157. The previous ileal neobladder techniques were Hautmann neobladder, detubularized U shape, or spherical shape neobladder.Surgical proceduresDipping technique was performed in 74 UIAS. Detour technique was done in 60 renal units. Ileal Bladder flap was indicated in 23 renal units. Each procedure ended with insertion of double J, abdominal drain, and indwelling catheter.Results:
Follow-up was done for 12 to 36 months. Patency of the anastomosis was found in 91.7 % of cases. Thirteen patients (8.3%) underwent antegrade dilatation and insertion of double J.Conclusion:
After endourological treatment for uretero-ileal anastomotic failure, basically three techniques may be indicated dipping technique, detour technique, and ileal bladder flap. The indications are dependent on the length of the stenotic/dilated ureteral segment. Better results for long length of stenotic ureter are obtained with detour technique; for short length stenotic ureter dipping technique; when the stenotic segment is 5 cm or more with a short ureter, the ileal tube flap is indicated. The use of double J stent is mandatory in the majority of cases. Early intervention is the rule for protecting renal units from progressive loss of function.
Full text:
Available
Index:
LILACS (Americas)
Main subject:
Urologic Surgical Procedures
/
Ureteral Obstruction
/
Ureterostomy
/
Ileal Diseases
Type of study:
Etiology study
/
Observational study
/
Prognostic study
Limits:
Female
/
Humans
/
Male
Language:
English
Journal:
Int. braz. j. urol
Journal subject:
Urology
Year:
2015
Type:
Article
Affiliation country:
Egypt
Institution/Affiliation country:
Theodor Bilharz research Institute/EG
Similar
MEDLINE
...
LILACS
LIS