ABSTRACT
Urinary bladder plastic repair with a gastric segment on a. et v. gastroepyploici dex was made in 22 patients (18 males, 4 females, mean age 58.2 years) from November 2001 to June 2003. Gastrocystoplasty was made in 17 patients after radical cystectomy for urinary bladder cancer, and in 5 patients with neurogenic and small urinary bladder. Three patients have undergone surgery in our modification with a complete cross resection of the gastric body with the lesser curvature. Lethal outcomes were absent. Follow-up for 2-22 months demonstrated that all the patients achieved positive functional results and good quality of life.
Subject(s)
Cystectomy , Plastic Surgery Procedures/methods , Pylorus/surgery , Pylorus/transplantation , Tissue Transplantation/methods , Urinary Bladder/surgery , Adult , Aged , Female , Humans , Male , Middle Aged , Transplantation, Autologous , TransplantsABSTRACT
The paper presents the results of 114 radical cystectomies made in 1996-2002. The age of 114 patients (103 males, 11 females) ranged from 37 to 78 years (mean age 57.5 years). Transient cell carcinoma was diagnosed in 81.5% patients. Supravesical urine derivation was conducted by means of ureterocutaneostomy and transureteroureteronephrostomy in 9 (7.9%) patients, ureterosygmoanastomosis--in 43 (37.7%) patients, artificial orthotopic urinary bladder was created in 7 (6.1%) patients of a gastric segment and in 55 (48.2%) patients of the ileum. Postoperative complications were observed in 28 (24.6%) patients, intestinal obstruction being a prevailing complication. Five patients died: 2 of pulmonary artery thromboembolism, 1 of acute cardiac failure, 1 of sepsis and 1 of gastric bleeding. Continent methods of urine derivation were preferred, such as ureterosygmoanastomosis by Mainz-Pouch II and creation of orthotopic urinary bladder of the stomach or of the ileum.
Subject(s)
Cystectomy/methods , Treatment Outcome , Adult , Aged , Carcinoma, Transitional Cell/diagnosis , Female , Humans , Male , Middle Aged , Postoperative Complications , Retrospective Studies , Russia , Time Factors , Urinary Diversion/methods , Urinary Incontinence/surgery , Urinary Reservoirs, Continent/statistics & numerical dataABSTRACT
In patients with inoperable cancer of the urinary bladder complicated by uretherohydronephrosis, chronic pyelonephritis, chronic renal failure, profuse bleedings from the tumor and pronounced dysuria, the supravesical derivation of urine is thought to be vitally indicated in spite of the unfavourable prognosis of the basic disease. First, it is necessary to provide the adequate drainage of the upper urinary ducts and kidneys followed by making favourable conditions for their longer and good functioning.
