INVERTING ORTHOTOPIC ILEOCYSTOPLASTY FOR SHORT MESENTERY
https://doi.org/10.17650/1726-9776-2010-6-2-37-44
Abstract
During orthotopic ileocystoplasty, the short mesentery causes an increase in the risk of incompetence of anastomosis of the reservoir with the urethra. Inverting orthotopic ileocystoplasty ensures a free reservoir pull-through into the small pelvis and eliminates tissue tension in the anastomosis. The proposed procedure differs from the Studer operation in that the reservoir is sutured lengthwise, after which it is inverted between the mesenteric leaves. The posterior reservoir wall is anteverted and freely brought out into the small pelvis. This reduces the distance to the urethral stump by 3-4 cm. This procedure was used in 19 patients to be operated on. There were no cases of reservoir or reservoir-urethral anastomotic incompetence. The mean neocystic capacity was 110, 350, and 490 ml 0, 3, and 12 months, respectively, after urethral catheter removal. The maximum reservoir pressure does not exceed 40 (mean 30) cm H2O. Daytime urinary retention was 94.7%; nocturnal urinary retention during forced nocturnal miction was 79%. The obtained functional results compare well with those achieved during the similar procedures.
About the Author
V. A. Perepechay
Southern District Medical Center, Federal Biomedical Agency of Russia, Rostov-on-Don
Russian Federation
Russian Federation
References
1. Camey M., Le Duc A. Le entroplasty après cystoprostatectomie total pour cancer de la vessie. Eur Urol 1979;13:114-23.
2. Lilien Q.M., Camey M. 25 year experience with replacement of the human bladder (Camey Procedure). J Urol 1984;132:886-91.
3. Le Duc A., Camey M., Teillac P. An original antireflux ureteroileal implantation technique: long-term follow up. J Urol 1987;137:1156-8.
4. Roehrborn C.G., Teigland C.M.,Sagalowsky A.I. Functional characteristics of the Camey ileal bladder. J Urol 1987;138:739-42.
5. Camey M., Botto H., Richard E. Complications of the Camey procedure. Urol Clin North Am 1988;15:249-55.
6. Ramon J., Leandri P., Rossignol G.,Botto H. Orthotopic bladder replacement using ileum: techniques and results. In: Reconstructive urology. Webster G.D., Kirby R., King L.R., Goldwasser В. eds. Oxford: Blackwell Scientific Publications, 1993. p. 445-57.
7. Коган М.И., Перепечай В.А. Современ-ная диагностика и хирургия рака мочевого пузыря. Ростов н/Д, 2002.
8. Steven K., Poulsen A.L. The orthotopic Kock ileal neobladder: functional results, urodynamic features, complications and survival in 166 men. J Urol 2000;164:288-95.
9. Elmajian D.A., Stein J.P., Esrig D. et al. The Kock ileal neobladder: updated experience in 295 male patients. J Urol 1996;156:920-5.
10. Shaaban A.A., Mosbah A., El-Bahnasawy M.S. et al. The urethral Kock pouch: long-term functional and oncological results in men. Br J Urol Int 2003;92:429-35.
11. Hautmann R.E., Egghart G.,Frohneberg D., Miller K. The ileal neobladder. J Urol 1988;139:39-42.
12. Stein J.P., Boyd S.D. In: Carcinoma of the bladder: innovations in management Petrovich Z., Baert L., Brady L.W. eds. Berlin, 1998. p. 155-68.
13. Kock N.G., Ghoneim M.A., Lycke K.G.,Mahran M.R. Replacement of the bladder by the urethral Kock pouch: functional results, urodynamics and radiological features. J Urol 1989;141:1111-6.
14. Studer U.E., Ackermann D.,Casanova G.A., Zingg E.J. Three years' experience with an ileal low pressure bladder substitute. Br J Urol 1989;63:43-52.
15. Studer U.E., Danuser H., Thalmann G.N. et al. Antireflux nipples or afferent tubular segments in 70 patients with ileal low pressure bladder substitutes: Long term results of a prospective randomized trial. J Urol 1996;156:1913-7.
16. Wright E.J. Urinary diversion. In: Scientific foundations and clinical practice.
17. K.J. Kreder, A.R. Stone eds. 2nd ed. London -NY, 2005. p. 135-41.Hautmann R.E. Urinary diversion: ileal conduit to neobladder. J Urol 2003; 169:834-42.
18. Zinman L.N. III, Bihrle W. In: Bladder reconstruction and continent urinary diversion.L.R. King, A.R. Stone, G.D. Webster eds. 2nded. St. Louis, 1991. p. 68-87.
19. Leadbetter W.F., Clarke B.G. Five years experience with uretero-enterostomy by the «combained» technique. J Urol 1955;73:67-70.
20. Schwaibold H., Friedrich M.G.,Fernandez S. et al. Improvement of ureteroileal anastomosis in continent urinary diversion with modified Le Duc procedure. J Urol 1998;160:718-20.
21. Levinson A.K., Johnson D.E.,Wishnow K.I. Indications for urethrectomy in an era of continent urinary diversion. J Urol 1990;144:73.
22. Steers W.D. Voiding dysfunction in the orthotopic neobladder. World J Urol 2000;18:330-7.
23. Морозов А.В., Павленко К.А. Орто-топический «энтеро-неоцистис» низко-го давления. М.: Медпрактика-М, 2006. c. 66-7.
24. Hautmann R.E., Paiss Т., Petriconi R. The ileal neobladder in women: 9 years experience with 18 patients. J Urol 1996;155:76.
25. Camey M. Radical cystoprostatectomy with ileocystoplasty. J Urol 1985;133:278.
26. Boyd S.D., Skinner D.G., Lieskovsky G. In: Bladder reconstruction and continent urinary diversion. L.R. King, A.R. Stone, G.D. Webster eds. 2nd Ed. St. Louis, 1991. p. 383-410.
27. Chang S.S., Cole E., Cookson M.S. et al. Preservation of the anterior vaginal wall during female radical cystectomy with orthotopic urinary diversion: technique and results. J Urol 2002;168:1442-5.
28. Латыпов В.Р. и др. Патент РФ №2279254, 2004.
29. Красный С.А., Суконко О.Г.,Поляков С.Л., Волков А.Н. Первый опыт применения нового метода формирования континентного гетеротопи-ческого резервуара после цистэктомии. www. urobel.uroweb.ru; 20.07.2007.
30. Перепечай В.А. Обоснование ортотопической сигмоцистопластики для вос-становления мочевого пузыря. Дис. … канд. мед. наук. Ростов н/Д, 2000.
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For citations:
Perepechay V.A. INVERTING ORTHOTOPIC ILEOCYSTOPLASTY FOR SHORT MESENTERY. Cancer Urology. 2010;6(2):37-44. (In Russ.) https://doi.org/10.17650/1726-9776-2010-6-2-37-44
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