A Novel Antireflux Technique for Orthotopic Ileal Bladder Substitutes—Flat-Segment Technique: Preliminary ResultsReportar como inadecuado




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ISRN UrologyVolume 2011 2011, Article ID 431951, 6 pages

Clinical StudyUrology Department, Kasr Al Aini Hospitals, Cairo University, Cairo, Egypt

Received 20 June 2011; Accepted 11 July 2011

Academic Editors: P.-L. Chang and C. E. Constantinou

Copyright © 2011 Hany ElFayoumy et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. Although a large debate exists regarding the need for reflux prevention in ileal orthotopic neobladders, it is our policy to continue performing nonrefluxing ureteroileal anastomoses for our patients. An ideal uretero-ileal anastomosis must be simple, nonrefluxing, as well as non-obstructive. Here, we present a new antireflux mechanism for orthotopic ileal neobladders. Methods. 12 radical cystectomy patients for muscle invasive bladder cancer were candidates for orthotopic urinary diversion and underwent a non-refluxing uretero-ileal anastomosis using the flat-segment technique with a follow up of 6 to 18 months. Results. Preliminary results after the short-term followup showed that the success rate in reflux prevention was 92% and no cases of obstruction. The upper tracts were preserved or improved in all 12 patients. Operative time for neobladder creation ranged between 120–240 minutes, with a mean of 165 minutes ±36 minutes. No diversion-related complications. Conclusions. Based on our early data, we believe that the flat-segment uretero-ileal anastomosis technique for reflux prevention in orthotopic ileal bladder substitutes is simple, easy to learn and carries no additional morbidity to a standard refluxing uretero-ileal anastomosis, but has the advantage of effective reflux prevention. A longer follow-up period study with more patient numbers is ongoing.





Autor: Hany ElFayoumy, Ashraf Abou-Elela, Tamer Orban, Ashraf Emran, Mohamed Elghoneimy, and Ahmed Morsy

Fuente: https://www.hindawi.com/



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