Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples-long term follow-up
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....
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Sociedade Brasileira de Urologia
2013-04-01
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doaj-930c44a0438f475b9201ee82602420852020-11-24T21:24:24ZengSociedade Brasileira de UrologiaInternational Brazilian Journal of Urology1677-55381677-61192013-04-01392167172Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples-long term follow-upSergey KravchickLeonid LobikAdrian PazEugeny StepnovDavid Ben-DorShmuel CytronPurposes 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.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382013000200167blabber neoplasmcystectomylaparoscopyurinary diversion |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Sergey Kravchick Leonid Lobik Adrian Paz Eugeny Stepnov David Ben-Dor Shmuel Cytron |
spellingShingle |
Sergey Kravchick Leonid Lobik Adrian Paz Eugeny Stepnov David Ben-Dor Shmuel Cytron Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples-long term follow-up International Brazilian Journal of Urology blabber neoplasm cystectomy laparoscopy urinary diversion |
author_facet |
Sergey Kravchick Leonid Lobik Adrian Paz Eugeny Stepnov David Ben-Dor Shmuel Cytron |
author_sort |
Sergey Kravchick |
title |
Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples-long term follow-up |
title_short |
Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples-long term follow-up |
title_full |
Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples-long term follow-up |
title_fullStr |
Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples-long term follow-up |
title_full_unstemmed |
Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples-long term follow-up |
title_sort |
radical cystectomy with w-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples-long term follow-up |
publisher |
Sociedade Brasileira de Urologia |
series |
International Brazilian Journal of Urology |
issn |
1677-5538 1677-6119 |
publishDate |
2013-04-01 |
description |
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. |
topic |
blabber neoplasm cystectomy laparoscopy urinary diversion |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1677-55382013000200167 |
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