Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples-long term follow-up
Int. braz. j. urol
;
39(2): 167-172, Mar-Apr/2013. graf
Article
Dans Anglais
| LILACS
| ID: lil-676252
ABSTRACT
Purposes We retrospectively assessed our experience with the W-shaped orthotopic ileal pouch, which was constructed with non –absorbable titanium staples. For these purpose, we discuss the results of bladder capacity, urinary continence and early and long-term postoperative complications. Materials and Methods We included in the study 17 patients who underwent radical cystoprostatectomy followed by construction of an orthotopic W-shaped ileal pouch between October 2000 and November 2009. A 65-70 cm segment of ileum was isolated and prearranged into a W- configuration, leaving two 10 cm intact segments on both sides of the ileal fragment. In our technique we entirely anatomized all adjacent limbs in order to create a sphere-shaped pouch. The ureters were directly anastomized to both intact segments of the ileal division. All our patients underwent pouchscopy 6 months after operation and annually. Results Mean operative time for neobladder reconstruction and ureteral anastomoses was 87 ± 7.67 minutes. In one patient a leak from the ileo-ileal anastomosis was confirmed on the 3rd day after operation. In 2 cases unilateral stricture of the ureteral-neobladder anastomosis was documented. Staple lines were mostly covered with ileal mucosa after 6 months. The mean functional bladder capacity was 340 ± 27.6 mL and 375 ± 43.4 mL at 6 and 12 months, respectively. First-year daytime and nighttime continence was good and acceptable in 90% and 78% of patients, while it increased to 95% during the 2nd year. Conclusions The long term follow-up shows that non-absorbable titanium staples can be safely used for creation of an orthotopic ileal neobladder. However, these data should be further validated in a larger series of patients. .
Texte intégral:
Disponible
Indice:
LILAS (Amériques)
Sujet Principal:
Titane
/
Tumeurs de la vessie urinaire
/
Carcinomes
/
Cystectomie
/
Agrafage chirurgical
/
Poches coliques
Type d'étude:
Étude observationnelle
/
Étude pronostique
Limites du sujet:
Adulte
/
Adulte très âgé
/
Humains
/
Mâle
langue:
Anglais
Texte intégral:
Int. braz. j. urol
Thème du journal:
Urologie
Année:
2013
Type:
Article
Pays d'affiliation:
Israël
Institution/Pays d'affiliation:
Barzilai Med. Center/IL
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