Long-term Functional Outcomes in Patients With a W-shaped Ileal Orthotopic Neobladder With No Antireflux Mechanism

Minervini, Andrea; Mariani, Chiara; Pagni, R; Santarsieri, Michele; Morelli, Girolamo; Giannese, Domenico; Ficarra, Vincenzo; Minervini, R.

doi:10.1016/j.urology.2013.05.030

Cited by 3 publications

(1 citation statement)

References 30 publications

(30 reference statements)

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“…Neither of these is perfect. The literature has implied that anti-reflux anastomotic techniques are effective in preventing reflux but have more stenotic complications [5,6]. Reflux techniques are relatively easier to perform with lower stenosis rates in longterm follow-up, but also might have drawbacks on renal function because of vesicoureteral reflux, especially during voiding due to increasing bladder luminal pressure [7].…”

Section: Introductionmentioning

confidence: 99%

A new ureteroileal anastomosis technique in modified ileal orthotopic bladder substitution after radical cystectomy

Pan

Yao

et al. 2020

World J Surg Onc

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Background: The aim of this study is to describe a modified technique in ileal orthotopic bladder substitution with a new ureteroileal anastomosis. Case presentation: After a classic open radical cystectomy with bilateral pelvic lymphadenectomy was performed extraperitoneally, a 56-cm ileal segment was used to construct the spheroidal shape bladder substitution. The 8-cm long proximal and distal ends of the ileal segment were used as afferent limbs. Two-centimeter ileal segments of afferent limbs were detubularized and transversally tubularized. The elongated ileal tube was anastomosed with the ureter in an end-to-end fashion. The pathway of the ureteroileal anastomosis was placed between the abdominal cutaneous fat and the anterior rectus muscular sheath. Perioperative data and long-term functional outcomes were assessed. Between December 2011 and December 2015, seven male patients underwent this procedure with a median 46 (30-77) months follow-up in our hospital. There was no difference between preoperative and postoperative estimated glomerular filtration rates (Z = − 1.693, P = 0.09). One of 14 sides had ureteroileal anastomotic stenosis; two of 14 sides in one patient had ureteroileal anastomotic stenosis caused by invasion of pelvic recurrence 15 months postoperatively. Reflux was completely prevented by placing pressure on the corresponding point on the abdominal surface when voiding urine in all patients. Conclusions:We describe a feasible technique modification in detail, which provides some advantages for effective anti-reflux by mechanical finger pressing and abdominal contraction, a low incidence of stricture, and ease for a secondary operation in the long-term follow-up period.

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Section: Introductionmentioning

confidence: 99%

A new ureteroileal anastomosis technique in modified ileal orthotopic bladder substitution after radical cystectomy

Pan

Yao

et al. 2020

World J Surg Onc

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La néovessie iléale en W : résultats fonctionnels et qualité de vie à long terme

Belot

Fassi-Fehri

Colombel

et al. 2016

Progrès en Urologie

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Current indications and results of orthotopic ileal neobladder for bladder cancer

Minervini

Serni

Vittori

et al. 2014

Expert Review of Anticancer Therapy

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During the past three decades, the reconstructive aspects of urologic surgery emerged and became a major component of our surgical specialty, and the most relevant developments have been observed in the field of urinary diversions. Health-related quality of life and self esteem have been improved following orthotopic bladder substitutions, which are actually the preferred method for continent urinary diversion. Patients with neobladders have enhanced cosmesis and the potential for normal voiding function with no abdominal stoma. Patient's selection for orthotopic neobladder formation is mandatory as most of the surgical complications or consequences associated with a neobladder are correlated not only with surgical technique or management after surgery, but also with wrong patient's selection. The principles of intestinal detubularization and reconfiguration to obtain spherical reservoir are the basis of continent urinary diversions and ileum seems to be preferable over any other segment. Nowadays, ileal neobladder is a widely adopted solution after cystectomy with a neobladder rate of 9-19% for population-based data with an increase to 39.1-74% for high-volume centers. However, controversies still exist in this urological field about the best candidates for neobladder construction, the best type of neobladder to offer, whether or not an antireflux uretero intestinal anastomosis should be used, the future of minimally invasive approaches, that is, robotic assisted cystectomy plus extracorporeal or intracorporeal neobladder, and last but very important, the functional results and the level of symptoms-induced distress and quality of life in the long term in patients with bladder cancer receiving an orthotopic bladder substitution. All these issues are discussed on the basis of the most recent published data.

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Long-term Functional Outcomes in Patients With a W-shaped Ileal Orthotopic Neobladder With No Antireflux Mechanism

Cited by 3 publications

References 30 publications

A new ureteroileal anastomosis technique in modified ileal orthotopic bladder substitution after radical cystectomy

A new ureteroileal anastomosis technique in modified ileal orthotopic bladder substitution after radical cystectomy

La néovessie iléale en W : résultats fonctionnels et qualité de vie à long terme

Current indications and results of orthotopic ileal neobladder for bladder cancer

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