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Orthotopic Neobladder Reconstrution: Postoperative CT Appearance, Complications and Potential Pitfalls
Journal of the Korean Radiological Society ; : 113-118, 2003.
Artigo em Coreano | WPRIM | ID: wpr-95456
ABSTRACT

PURPOSE:

To evaluate the postoperative CT appearance, complications and potential pitfalls of radical cystectomy with orthotopic neobladder reconstruction. MATERIALS AND

METHODS:

We examined 46 patients [43 men and 3 women aged 34-72 (mean, 56.7) years] who had undergone neobladder reconstruction (ileocolic neobladder in 25 patients and ileal-W neobladder in 21). The CT scans were assessed in terms of their depiction of normal anatomy, namely the shape, location and internal architecture of the neobladder, the location of bladder bases, and the ureteral course. Early and late complications were also assessed.

RESULTS:

The characteristics of ileocolic neobadder were a right-side location, a lobulated outer margin, internal projections due to haustra or plication, a base in the retropubis, and right-side insertion of both ureters. In contrast, the characteristics of an ileal-W neobladder were a central location, an ovoid shape, nodular thickening at the ureteral insertion site, internal projections due to plication, and a retropubic bladder base. Early complications included hematoma with abscess formation (n=2), and postoperative peritonitis (n=1), while late complications were hydronephrosis due to stricture at the ureteral anastomotic site (n=16), tumor recurrence at this site (n=1), distal ureteral stone (n=1), mucus urinary retention (n=1), incisional hernia (n=2), tumor recurrence in the pelvic side wall (n=1), carcinomatosis peritonei (n=1), and liver metastasis (n=2).

CONCLUSION:

A knowledge of normal anatomic changes is essential for the accurate interpretation of CT scans. CT is a useful modality for the evaluation of postoperative change and the complications occurring in patients who have undergone radical cystectomy with othotopic neobladder reconstruction.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Peritonite / Recidiva / Ureter / Bexiga Urinária / Carcinoma / Tomografia Computadorizada por Raios X / Cistectomia / Retenção Urinária / Constrição Patológica / Abscesso Limite: Feminino / Humanos / Masculino Idioma: Coreano Revista: Journal of the Korean Radiological Society Ano de publicação: 2003 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Peritonite / Recidiva / Ureter / Bexiga Urinária / Carcinoma / Tomografia Computadorizada por Raios X / Cistectomia / Retenção Urinária / Constrição Patológica / Abscesso Limite: Feminino / Humanos / Masculino Idioma: Coreano Revista: Journal of the Korean Radiological Society Ano de publicação: 2003 Tipo de documento: Artigo