Modified technique for improving tubeless cutaneous ureterostomy by Ariyoshi method

Wada, Yasuhiko; Kikuchi, Ken; Imamura, Takahisa; Suenaga, Takatoshi; Matsumoto, Koichiro; Kodama, Kodo

doi:10.1111/j.1442-2042.2007.01948.x

Cited by 13 publications

(11 citation statements)

References 15 publications

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“…The drawback of CU is a high rate of late stomal stenosis limiting its widespread use, and preserving this method of diversion for morbid patients [ 7 , 18 ]. Recent advancements in the surgical technique and modifications, however, have improved the rate of stomal stenosis proposing this method as an option for existing surgical gold standards in selected patients [ 8 , 17 , 19 ].…”

Section: Discussionmentioning

confidence: 99%

Assessment of health-related quality of life of male patients with ileal orthotopic neobladder compared to cutaneous ureterostomy

Tsaturyan

Beglaryan

Kirakosyan

et al. 2020

Cent european J Urol

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Introduction The aim of this article was to compare patients’ health-related quality of life (HR-QoL) outcomes between ileal orthotopic neobladder (IONB) and standard bilateral cutaneous ureterostomy (CU) using validated diversion-specific HR-QoL questionnaires. Material and methods This study utilized a retrospective cohort design, including all male patients who underwent open radical cystectomy with either IONB or CU from January 2010 until December 2017. In total, 69 and 57 male patients with a minimum of 12 months of follow-up were included in each group respectively, after applying the following exclusion criteria: female, pre- and postoperative radio- and chemotherapy and palliative surgery. For every patient, HR-QoL was evaluated using the European Association of Research and Treatment of Cancer Quality of Life Core (EORTC-QLQ-C30) and Functional Assessment of Cancer Therapy for patients undergoing radical cystectomy (FACT-Bl-Cys) validated questionnaires. Results In multivariable analysis, the type of the urinary diversion, and the occurrence of early and late postoperative complications were independently associated with the change of scores of HR-QoL domains. When comparing the 2 surgical methods (IONB vs. CU), after adjusting for confounders, such EORTC-QLQ-C30 domains as physical functioning (66.5 vs. 57.9, p = 0.011) and global health status (58.1 vs. 42.6, p <0.001) were superior in the IONB arm which was statistically significant. Similarly, functional health (15.3 vs. 11.9, p <0.001) and total score (110.1 vs. 101.7, p = 0.009) from the FACT-Bl-Cys questionnaire were superior in the IONB arm. Conclusions In our study, patients with IONB possessed statistically significant, better scores of HR-QoL domains assessed with EORTC-QLQ-C30 and FACT-Bl-Cys questionnaires compared to those with CU. The occurrence of early major and late complications negatively affected patients’ HR-QOL.

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Section: Discussionmentioning

confidence: 99%

Assessment of health-related quality of life of male patients with ileal orthotopic neobladder compared to cutaneous ureterostomy

Tsaturyan

Beglaryan

Kirakosyan

et al. 2020

Cent european J Urol

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“…In such cases, the usual site of cutaneous ureterostomy (lower quadrant of the abdominal wall) may be too remote to achieve a catheter-free state. 11 More than 50% of the patients develop stenosis and require periodic dilation or long-term intubation. 12 Alternatively, an umbilical cutaneous ureterostomy avoids the long midline scar and reconstruction is easier compared with that in urinary diversions using intestine.…”

Section: Discussionmentioning

confidence: 99%

Clinical benefits of tubeless umbilical cutaneous ureterostomy

Numakura

Tsuchiya

Takahashi

et al. 2015

CUAJ

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Introduction: We assess a novel technique of tubeless bilateral cutaneous ureterostomy, with a single umbilical stoma, for bladder cancer patients with short ureters after cystectomy. The benefit of cutaneous ureterostomy is equal to other incontinent urinary diversions, when the tubeless procedure is successfully achieved. This simple technique makes it easy to monitor the upper urinary tract (UUT) and is beneficial to patients with a high risk of UUT recurrence. Methods: This old and new surgical technique was used to perform total cystectomy and urinary diversion on three patients with bladder cancer at a high risk of UUT recurrence. Results: Two men and one woman (mean age: 73 years) underwent this surgery and the mean follow-up period was 8.3 years. The surgical approaches were laparotomy (n = 2) and laparoscopy (n = 1). One case developed para-stomal erosion, whereas another developed ureteral stenosis requiring catheter reinsertion. Although postoperative hydronephrosis was observed in all cases, the mean preoperative and postoperative serum creatinine levels were 0.70 and 0.76, respectively. UUT recurrence was not observed during the follow-up period. Conclusion: This tubeless umbilical cutaneous ureterostomy procedure greatly improves the outcome of urinary diversion for cancer patients with short ureters at a high risk of UUT recurrence. The benefits are equivalent to other urinary diversions when the tubeless procedure is successfully achieved.

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“…Unlike Toyoda's method and its modifications, our method involved a nipple formation similar to IC. Wada et al [11] described their technique for maintaining ureteral blood preservation. They implemented Ariyoshi's techniques and added that the fascia between spermatic cord and ureter, which was usually cut, played a significant role.…”

Section: Joj Urology and Nephrologymentioning

confidence: 99%

Single Stoma Tubeless Cutaneous Ureterostomy: A New Approach to an Old Operation

Oganov¹

2017

JOJUN

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Introduction: Cutaneous ureterostomy is the simplest and safest way for incontinent urinary diversion associated with the lowest rate of early postoperative gastrointestinal and metabolic complications; however, its use is limited because of high rate of stomal stenosis, making ileal conduit the standard method for incontinent urinary diversion.Aim: Present our technique of constructing single site tubeless cutaneous ureterostomy as a valid alternative to ileal conduit.Patients and surgical method: Ten patients underwent the radical cystectomy followed by single stoma tubeless cutaneous ureterostomy. The main differences of our method from previously described techniques were the preservation of parietal peritoneum covering the ureters as a mean for better blood supply preservation and fixation of ureteral orifices one to another forming one oval shaped stoma.Result: One out of ten patients experienced stricture of the stoma meaning requiring a reconstructive surgery on stoma. Other patients were free of obstruction at six month and 12-month period. Conclusion:Cutaneous ureterostomy is a safe method, which is the preferred method of urinary diversion for morbid patients. We believe that modified single stoma tubeless cutaneous ureterostomy could become a method of choice not only for morbid patients but also for patients who are candidates for IC.

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Modified technique for improving tubeless cutaneous ureterostomy by Ariyoshi method

Cited by 13 publications

References 15 publications

Assessment of health-related quality of life of male patients with ileal orthotopic neobladder compared to cutaneous ureterostomy

Assessment of health-related quality of life of male patients with ileal orthotopic neobladder compared to cutaneous ureterostomy

Clinical benefits of tubeless umbilical cutaneous ureterostomy

Single Stoma Tubeless Cutaneous Ureterostomy: A New Approach to an Old Operation

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