Cystectomy and Urinary
Diversion during Twenty Years -
Complications and Metabolic
Implications

Jahnson, Staffan; Pedersen, J.

doi:10.1159/000474326

Cited by 38 publications

(12 citation statements)

References 17 publications

(24 reference statements)

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“…In the present series, there was no peri-operative irradiated groups [7]. In all three patients who ation between early complications after urinary diversion and pre-operative irradiation.…”

Section: Discussion Resultsmentioning

confidence: 47%

High‐dose pelvic irradiation followed by ileal neobladder urinary diversion: complications and long‐term results

Gschwend

Maÿ

Paiss

et al. 1996

British Journal of Urology

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Objective To determine the risk of post-operative group of non-irradiated patients, and no patients died. The mean follow-up was 22 months (range 10-37) complications in patients receiving high-dose pelvic irradiation before radical cystectomy and urinary and revealed satisfactory results in seven of 11 patients. A neovesicoperitoneal fistula developed in diversion. Patients and methods Of 300 patients who underwent one woman 10 months after surgery and was repaired by laparotomy. A neovesicovaginal fistula led to sup-orthotopic bladder replacement at our institution from 1986 to 1994, 11 patients (mean age 63 years, range ravesical urinary diversion in the second woman. Conclusions High-dose pelvic irradiation should not be 53-74) did so after receiving high-dose pelvic irradiation. The indication for cystectomy and urinary a primary contra-indication for orthotopic urinary diversion using segments of small intestine. For reconstruction was bladder cancer in seven men, prostate cancer in two men and a contracted bladder patients who undergo combined external and afterloading radiotherapy, the indication for orthotopic due to combined external pelvic irradiation and afterloading radiotherapy in two women.bladder replacement should be considered critically. Keywords Pelvic irradiation, ileal neobladder, compli-Results The post-operative course, including the duration of hospital stay, peri-operative complications and cations, results early functional results, did not differ from a control rates of anastomotic leakage, upper urinary tract

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Section: Discussion Resultsmentioning

confidence: 47%

High‐dose pelvic irradiation followed by ileal neobladder urinary diversion: complications and long‐term results

Gschwend

Maÿ

Paiss

et al. 1996

British Journal of Urology

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“…In other reports, however, vitamin B,, deficiency was found in only 3.3% of patients with an ileal neobladder,s and in none of 22 pediatric patients who had bladder replacement or augmentation using less than 45cm of ileum.…”

Section: Introductionmentioning

confidence: 75%

Vitamin B₁₂ Deficiency in Patients with Urinary Intestinal Diversion

et al. 1997

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Background: Because vitamin B,, is absorbed exclusively by the terminal ileum, we investigated vitamin B,, deficiency as a potential metabolic complication after urinary intestinal diversion. Methods:We measured serum levels in patients with Kock pouches (n = 35); Indiana pouches ( t i = 27); and ileal conduits (n = 25). Serial determinations of serum BIL levels were obtained in 19 patients with Kock pouches and 14 patients with Indiana pouches. The dual-isotope Schilling test was performed in 9 patients with Kock pouches and 6 patients with Indiana pouches.Results: N o patient had an abnormally low serum BIL level (< 200 pdmL). Mean (f SD) serum B,, levels in patients with the Kock pouch (506 f 202 pg/mL) and the Indiana pouch (536 f 249 pg/mL) were lower than that in patients with the ileal conduit (727 f 391 pg/mL). The mean serum B,, level was not significantly different between patients with and without preoperative irradiation. Serial determinations showed that serum B,, levels in some patients with continent urinary reservoirs were persistently near the lower normal limit, or became progressively lower. Three of the 9 patients (33%) with Kock pouches and 4 of the 6 patients (67%) with Indiana pouches were B,, malabsorbers, although no patients had megaloblastic anemia or neurologic symptoms.Conclusions: Some patients with continent urinary reservoirs are at risk for vitamin B,? deficiency due to malabsorption. Routine evaluation of serum B,, levels is recommended for all patients with continent urinary reservoirs, and a Schilling test for those with subnormal serum B,, levels.Int

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“…Despite reports indicating survival benefits, high incidences of complications have been reported after combined treatment with neoadjuvant radiotherapy and cystectomy [16,17]. It is possible, however, that modern radiotherapy innovations and principles with conformal radiotherapy reduce the morbidity of ionizing radiation on surrounding tissues such as intestines, and accordingly decrease unwanted side-effects.…”

Section: Discussionmentioning

confidence: 99%

Downstaging and survival benefits of neoadjuvant radiotherapy before cystectomy for patients with invasive bladder carcinoma

Granfors¹,

Tomić

Ljungberg

2009

Scandinavian Journal of Urology and Nephrology

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Cystectomy and Urinary Diversion during Twenty Years - Complications and Metabolic Implications

Cited by 38 publications

References 17 publications

High‐dose pelvic irradiation followed by ileal neobladder urinary diversion: complications and long‐term results

High‐dose pelvic irradiation followed by ileal neobladder urinary diversion: complications and long‐term results

Vitamin B₁₂ Deficiency in Patients with Urinary Intestinal Diversion

Downstaging and survival benefits of neoadjuvant radiotherapy before cystectomy for patients with invasive bladder carcinoma

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Cystectomy and Urinary Diversion during Twenty Years - Complications and Metabolic Implications

Cited by 38 publications

References 17 publications

High‐dose pelvic irradiation followed by ileal neobladder urinary diversion: complications and long‐term results

High‐dose pelvic irradiation followed by ileal neobladder urinary diversion: complications and long‐term results

Vitamin B12 Deficiency in Patients with Urinary Intestinal Diversion

Downstaging and survival benefits of neoadjuvant radiotherapy before cystectomy for patients with invasive bladder carcinoma

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Vitamin B₁₂ Deficiency in Patients with Urinary Intestinal Diversion