Short ileal segment for orthotopic neobladder: A feasibility study.
Summary of "Short ileal segment for orthotopic neobladder: A feasibility study."
Objectives: The objective of this study was to present the construction of a neobladder with a modified pouch technique using 25-35 cm of terminal ileum. Methods: Thirty-eight patients whose pouch was constructed from 25-35 cm of terminal ileum (short pouch [SP] group) were prospectively evaluated vs 41 patients whose pouch was constructed from 50-70 cm of terminal ileum (long pouch group). Pouch volume, post-void residual (PVR) volume, need for catheterization, continence and voiding frequency were evaluated at 3 and 12 months after surgery. Results: SP group patients had significantly smaller pouch capacity (440 vs 840 mL, P < 0.001) at month 12, and smaller PVR at postoperative months 3 (11 [0-43]vs 40 [0-147] mL, P < 0.001) and 12 (10 [0-90]vs 72 [0-570] mL, P < 0.001). SP group patients had significantly higher voiding frequency on postoperative month 3 (10 vs 9, P < 0.001) and 12 (7 vs 6, P < 0.005). Continence was significantly improved in the SP group compared with the long pouch group after 12 months (63.2% vs 34.1%, respectively, P = 0.034). Full continence improved significantly over time (P < 0.001) in the SP group, from 26.3% at month 3 to 63.2% at month 12. Conclusion: A pouch constructed from 25-35 cm of terminal ileum provides adequate capacity, smaller PVR, satisfactory continence and a better 24-h voiding frequency pattern during the first postoperative year.
Urology Clinic, Military Medical Academy, Belgrade, Serbia.
This article was published in the following journal.
Name: International journal of urology : official journal of the Japanese Urological Association
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20649826
- DOI: http://dx.doi.org/10.1111/j.1442-2042.2010.02599.x
Probably, laparoscopic radical cystectomy with ileal neobladder and neovesicourethral anastomosis is one of the most complex procedures in minimally invasive surgery.
To present a 2-institution experience with completely intracorporeal robotic orthotopic ileal neobladder following radical cystectomy in 132 patients.
We present a case where there was a delay in the diagnosis of severe metabolic acidosis in a patient with an orthotopic neobladder. There are a growing number of patients with orthotopic neobladders a...
In the recent years, robotic-assisted radical cystectomy (RARC) has shown similar oncological outcomes compared to the gold standard open radical cystectomy with added benefit of less blood loss and s...
To evaluate risk factors for urethral recurrence (UR) in women with neobladder.
This is a prospective, randomized study of two types of continent ileal neobladder construction in patients undergoing cystectomy for primary bladder cancer. Patients will be randomly assi...
Ileal interposition shifts a segment of ileum proximally to achieve maximal meal stimulated GLP-1 secretion and coupled with a restrictive procedure of sleeve gastrectomy helps in achievin...
Total proctocolectomy and ileal pouch-anal anastomosis is the surgical treatment of choice for patients with medically refractory ulcerative colitis, ulcerative colitis with dysplasia or c...
Increased intracranial pressure is a cause of disease progression in patients with brain disease, a common cause of poor prognosis. Intracranial pressure monitoring is the observation of t...
OBJECTIVES: I. Determine the effects of bile externalization and antibiotic gut sterilization on the pharmacokinetics of mycophenolate mofetil in patients who have undergone orthotopic li...
Medical and Biotech [MESH] Definitions
Studies to determine the advantages or disadvantages, practicability, or capability of accomplishing a projected plan, study, or project.
Congenital MEGACOLON resulting from the absence of ganglion cells (aganglionosis) in a distal segment of the LARGE INTESTINE. The aganglionic segment is permanently contracted thus causing dilatation proximal to it. In most cases, the aganglionic segment is within the RECTUM and SIGMOID COLON.
The light sensitive outer portion of a retinal rod or a cone photoreceptor cell. The outer segment contains a stack of disk membranes laden with photoreceptive pigments (RETINAL PIGMENTS). The outer segment is connected to the inner segment by a PHOTORECEPTOR CONNECTING CILIUM.
A segment of the immunoglobulin heavy chains, encoded by the IMMUNOGLOBULIN HEAVY CHAIN GENES in the J segment where, during the maturation of B-LYMPHOCYTES; the gene segment for the variable region upstream is joined to a constant region gene segment downstream. The exact position of joining of the two gene segments is variable and contributes to ANTIBODY DIVERSITY. It is distinguished from the IMMUNOGLOBULIN J CHAINS; a separate polypeptide that serves as a linkage piece in polymeric IGA or IGM.
Pathological development in the ILEUM including the ILEOCECAL VALVE.