Double Folded Rectosigmoid Bladder With a New Ureterocolic Antireflux Technique

El-Mekresh, Mohsen; Hafez, Ashraf T.; Abol‐Enein, Hassan; Ghoneim, Mohamed A.

doi:10.1016/s0022-5347(01)64681-0

Cited by 39 publications

(19 citation statements)

References 23 publications

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“…Many studies were evaluating results and its complications of ureterosigmoidostomy and its modifications. In our study early complications were presented in 23 (20%) patients while in other studies El-Mekresh et al [9]; 8 (14%), Gerhaz et al [10]; 4 (11.7%), Obek et al [11]; 2 (3.3%) and Omaya [12]; 6 (28.6%). Late complications (metabolic acidosis, upper urinary dilatation and pyelonephritis) in our study were 2.6%, 6% and 3.5% respectively compared to other studies El-Mekresh et al [9]; (0%, 5.3% and 3.5%), Gerhaz et al [10]; (5.8%, 2.9% and 2.9%), Obek et al [11]; (6%, 5% and 8%) and Omaya [12]; (4.7%, 9.5% and 4.7%).…”

Section: Discussionsupporting

confidence: 44%

“…In our study early complications were presented in 23 (20%) patients while in other studies El-Mekresh et al [9]; 8 (14%), Gerhaz et al [10]; 4 (11.7%), Obek et al [11]; 2 (3.3%) and Omaya [12]; 6 (28.6%). Late complications (metabolic acidosis, upper urinary dilatation and pyelonephritis) in our study were 2.6%, 6% and 3.5% respectively compared to other studies El-Mekresh et al [9]; (0%, 5.3% and 3.5%), Gerhaz et al [10]; (5.8%, 2.9% and 2.9%), Obek et al [11]; (6%, 5% and 8%) and Omaya [12]; (4.7%, 9.5% and 4.7%). In this study only 2 (1.7%) female patients had persistent night incontinence in comparison to other studies El-Mekresh et al [9]; 4 (7%), Gerhaz et al [10]; 1 (2.9%), Obek et al [11]; 1 (1.6%) and Omaya [12]; 1 (4.7%).…”

Section: Discussionsupporting

confidence: 44%

See 1 more Smart Citation

New Look on Ureterocolic Diversion with Adjuvant Radiotherapy; SECI (South Egypt Cancer Institute) Experience

Ahmed¹,

Aboeleuon²,

Abdel-Rahim³

et al. 2018

JCT

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Background: Ureterosigmoidostomy was the first form of continent urinary diversion and had broad popularity during the first half of the 20th century. Primary enthusiasm was followed by disappointment when serious problems such as pyelonephritis, electrolyte imbalance, renal calculi and renal function deterioration become evident. In the 1950s these life threatening complications led to avoid this urinary diversion in favor of uretro-intestinal conduits. Objectives: Our aim was to evaluate our experience in ureterocolic shunt after radical cystectomy for bladder cancer. Methodology: This study was conducted in surgical oncology department, South Egypt cancer institute, Assiut university; in the period from January 2012 to January 2017 and including 115 patients (75 males & 40 females). Results: This is retrospective study including 115 patients (75 males & 40 females). Operative time was 130 minutes ranging between 2 to 2.5 hours. Average blood loss was 450 ml. After removal of rectal tube all patients were continent except 15 patients who were improved after 1-3 days. Within a month 12 patients had night incontinence and 5 patients had day time incontinence. After that day and night continence gradually improved in all patients except two females who had persistent night soiling and was in need for night time rectal tube. Conclusion: Ureterosigmoidostomy regains the interest of surgical oncology and urologist because of its simplicity and absence of appliance as many patients refusing cutaneous stoma and others are not suitable for orthotopic substitutes.

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Section: Discussionsupporting

confidence: 44%

Section: Discussionsupporting

confidence: 44%

New Look on Ureterocolic Diversion with Adjuvant Radiotherapy; SECI (South Egypt Cancer Institute) Experience

Ahmed¹,

Aboeleuon²,

Abdel-Rahim³

et al. 2018

JCT

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“…Thus, by using the serous‐lined method the ileocaecal portion can be avoided for urinary reconstruction, which is important to prevent both diarrhoea and malabsorption syndrome [12]. Nevertheless, the serous‐lined technique could also be applied to the colonic segment [11,13]. The present experience of antirefluxing ureteric implantation and continent‐valve formation on the principle of the W‐shaped pouch has been good; dilated and normal ureters were implanted successfully with ideal results.…”

Section: Discussionmentioning

confidence: 99%

The serous‐lined tunnel principle for urinary reconstruction: a more rational method

et al. 2001

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Objective To examine the feasibility of using the serouslined-tunnel principle for orthotopic neobladder, continent cutaneous diversion and ureteric replacement by an intestinal segment. Patients and methods We created: (i) an orthotopic ileal neobladder using the serous-lined technique for antire¯uxing ureteric implantation in 16 patients; (ii) a continent ileal pouch, adopting the principle for continent-valve construction and for ureteric implantation, in 10 patients (another patient with a failed continent valve underwent revision using an adaptation of this principle; and (iii) by applying the same principle an ileal ureter with a proximal antire¯uxing mechanism was constructed in two patients (with lower ureteric cancer), and total replacement of the ureter by a tubular segment of the colon in association with a continent transverse colon pouch in one irradiated patient.Results In all, 52 ureters implanted into ileal neobladders or continent pouches functioned well, with neither obstruction nor re¯ux; 11 continent valves functioned well with no incontinence. Two patients with ileal ureters showed no ileo-ureteric re¯ux and had less hydronephrosis than before surgery. The tubularized ureter provided a unidirectional¯ow into the pouch. Conclusion Ureteric reimplantation and continent valve formation achieved by adopting the serous-lined tunnel principle provided satisfactory results. The versatility of the principle is apparent in the present experience and the creative application of the serouslined tunnel principle should be possible in urinary reconstruction.

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“…The same group later applied the extramural technique to a double‐folded rectosigmoid pouch in 64 patients during open surgery. In addition to a low ureteric stricture rate (5.3%) no patient had any clinical manifestations of acidosis (all patients were maintained on prophylactic alkalinization) [13]. The issue of ureteric anastomosis was also examined by Bastian et al.…”

Section: Discussionmentioning

confidence: 99%

Modified ureterosigmoidostomy (Mainz Pouch II): a nonrefluxing stented vs unstented laparoscopic porcine model

2007

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OBJECTIVE To describe a rapid and reproducible pure laparoscopic cystectomy and nonrefluxing modified continent urinary diversion (Mainz Pouch II), and to determine whether ureteric stenting decreases ureteric obstruction after surgery. MATERIALS AND METHODS After institutional review and approval, six female pigs (51–55 kg) had a laparoscopic cystectomy and urinary diversion using a modified Mainz Pouch II. Imbricating bowel over the extra‐intestinal ureteric segment created the nonrefluxing mechanism. All pigs had the same bowel preparation before a standard four‐port transperitoneal laparoscopic procedure, but three pigs received bilateral J ureteric stents and three did not. Body weights, radiographic imaging, serum electrolytes and renal function were monitored during the 6‐week survival period. RESULTS One stented pig developed bilateral pyelonephritis, renal obstruction and was killed. Including this pig, four of 12 renal units were obstructed, occurring more often in the stented pigs. There were no significant differences between the serum electrolytes before and after surgery or between the stented or unstented pigs. The surgery was quicker as experience increased. No pig developed hyperchloraemic metabolic acidosis. The nonrefluxing modification appeared to be effective, as reflux was only present in one renal unit. CONCLUSIONS Laparoscopic ureterosigmoidostomy, specifically the modified Mainz Pouch II, represents a viable and reasonable continent urinary diversion. The results suggest that there was no benefit in stenting in this pig model.

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Double Folded Rectosigmoid Bladder With a New Ureterocolic Antireflux Technique

Abstract: The procedure can circumvent some of the inherent disadvantages of ureterosigmoidostomy and is a good alternative to orthotopic bladder substitution when the urethra cannot be used.

Cited by 39 publications

References 23 publications

New Look on Ureterocolic Diversion with Adjuvant Radiotherapy; SECI (South Egypt Cancer Institute) Experience

New Look on Ureterocolic Diversion with Adjuvant Radiotherapy; SECI (South Egypt Cancer Institute) Experience

The serous‐lined tunnel principle for urinary reconstruction: a more rational method

Modified ureterosigmoidostomy (Mainz Pouch II): a nonrefluxing stented vs unstented laparoscopic porcine model

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