10 Years Experience in Using Direct Ureterointestinal Anastomosis in Urinary Intestinal Diversion after Radical and Simple Cystectomy


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Abstract

147 patients who underwent urinary intestinal diversion from 2004 to 2014 were selected for the retrospective study. The authors carried out a comparative analysis of rates of complications that arise from the direct ureterointestinal anastomosis. The mean age of patients was 54.2±3.0 (36-69) years. 60 (40.81%) patients of group 1 underwent Nesbits direct ureterointestinal anastomosis, while in 87 (59.19%) patients of group 2 Wallace-1 and Wallace-2 anastomoses were performed. Average followup was 5.6 (2-10) years. Strictures of ureterointestinal anastomosis were detected in 2 (3.38%) patients of group 1 and in 1 (1.14%) patient of group 2. In all cases re-anastomosis was performed. The maximum postoperative concentration of serum creatinine in both groups was 231mmol/l. According to radioisotope kidney scan, no differences in accumulative and excretory renal functions between two groups of patients were recorded. No kidney stone formation in both groups of patients during the followup period was observed. No ureteral reflux above grade 3 was noted. The clinical manifestation of reflux pyelonephritis was observed in 3.5% of the patients. Acute pyelonephritis was cured by antibacterial therapy.

About the authors

O B Loran

Russian Medical Academy of Postgraduate Education

Russian Medical Academy of Postgraduate Education

I V Serjogin

Russian Medical Academy of Postgraduate Education

Russian Medical Academy of Postgraduate Education

A L Hachatrjan

Russian Medical Academy of Postgraduate Education

Russian Medical Academy of Postgraduate Education

R I Guspanov

Russian Medical Academy of Postgraduate Education

Russian Medical Academy of Postgraduate Education

References

  1. Stenzl A., Nagele U., Kuczyk M., Sievert K.-D., Anastasiadis A., Seibold J. Cystectomy - technical considerations in male and female patients. EAU Update Series. 2005;3:138-146.
  2. Коган М.И., Перепечай В.А., Татьянченко В.К. и др. Анатомическое обоснование к выбору сегмента толстой кишки для создания мочевых резервуаров. Урол. и нефрол. 1995;6:28-32.
  3. Лопаткин H.A., Мартов А.Г., Даренков С.П. Оперативное лечение опухолей мочевого пузыря. Урол. и нефрол. 1999;1:26-31.
  4. Велиев Е.И., Лоран О.Б. Проблема отведения мочи после радикальной цистэктомии и современные подходы к ее решению. Практическая онкология. 2003;4:231-234.
  5. Комяков Б.К., Новиков А.И., Гулиев Б.Г., Дорофеев С.Я., Зубань О.Н., Атмаджев Д.Н. Восстановление мочевыводящих путей различными отделами желудочно-кишечного тракта. Урология. 2005;5:12-17.
  6. Лопаткин H.A., Пугачев А.Г., Москалева Н.Г. Интермиттирующий пузырно-мочеточниковый рефлюкс у детей. М.: Медицина, 2004. 136 с. 7.
  7. EdwardsD, NormandI.C.S., PrescodN, Smellie J.M. Disappearance of vesicoureteric reflux during long-term prophylaxis of urinary tract infection in children. BMJ. 1977;2:285-288.
  8. Gonzalez R., Reinberg ^Localization of bacteriuria in patients with enterocystoplasty and nonrefluxing conduits. J. Urol. 1987;138:1104-1105. 9.
  9. ГоцадзеД.Т. Отдаленные результаты континентного отведения мочи на кожу в детубуляризированный тонкокишечный резервуар. Урология. 2003;4:18-22.
  10. Abol-Enein H., Ghoneim M.A. A novel uretero-ilealreimplantation technique: the serous lined extramural tunnel. A preliminary report. J. Urol. 1994;151:1193-1197.
  11. Abol-Enein H., Ghoneim M.A. Functional results of orthotopicilealneobladder with serous-lined extramural ureteral reimplantation: experience with 450 patients. J. Urol. 2001;165:1427-1432.
  12. Hautmann R.E., DePetriconi R., Gottfried H.W., Kleinschmidt K., Mattes R., Paiss T. The ilealneobladder: complicacoins and functional results in 363 patients after 11 years of followup. J. Urol. 1999;161:422-428.
  13. Stein J.P., Lieskovsky G., Cote R., Groshen S., Feng A.C., Boyd S., Skinner E., Bochner B., Thangathurai D., Mikhail M., Raghavan D., Skinner D.G. Radical cystectomy in the treatment of invasive bladder cancer: long-term results in 1,054 patients. J. Clin. Oncol. 2001;19:666-675.
  14. Studer U.E., DanuserH., Thalmann G.N., Springer J.P., Turner W.H. 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;156:1913-1917.
  15. Studer U.E., Stenzl A., Mansson W., Mills R. Bladder replacement and urinary diversion. Eur. Urol. 2000;38:1-11. 16.
  16. Le Duc A., Camey M., Teillac P. An original antireflux implantation technique: long-term follow- up. J. Urol. 1987;137:1156-1160.
  17. Hautmann R.E. Neobladder and bladder replacement. Eur. Urol. 1998;33:1-10.
  18. Hautmann R.E. Urinary diversion:ileal conduit to neobladder. J. Urol. 2003;169:834-842.
  19. Perimenis P., Burkhard F.C., Studer U.E. Ilealorthotopic substitute combined with an afferent tubular segment: long-term upper urinary tract changes and voiding pattern. Eur. Urol. 2004;46:604-609.
  20. Kristjansson A., Wallin L., Mansson W. Renal function up to 16 years after conduit (refluxing or anti-reflux anastomosis) or continent urinary diversion. I Glomerular filtration rate and potency of ureterointestinal anastomosis. Brit. J. Urol. 1995;76:539-545.
  21. McDougal W.S. Use of intestinal segments and urinary diversion. Walsh P.C., Retik A.B., Vaughan E.D., Wein A.J., eds. Campbell's Urology, 8th edn. Philadelphia: WB Saunders, 2002. P. 3745-3788.

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