Segmental ureteroileal conduit resection for the treatment of distal upper urinary tract recurrence of bladder cancer following cystectomy

Zeng, Shuxiong; Lü, Xiaoying; Xu, Weidong; Zhang, Zhen‐Sheng; Li, Hai‐Hang; Sun, Yinghao; Xu, Chuanliang

doi:10.1186/s40880-015-0077-8

Cited by 4 publications

(7 citation statements)

References 22 publications

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“…No tumor infiltration was observed microscopically at the resection margins, although we were unable to remove the uretero-ileal anastomosis. Usually, however, the anastomosis should be removed using a technique such as segmental uretero-ileal conduit resection, as reported by Zeng et al 5 In this case, the second recurrence may be a recurrence of the residual ureter at the time of nephroureterectomy. In a report of 19 cases by Zattoni et al, the anastomosis was the most common site of recurrence after ileal conduit creation, and surgical resection was the treatment of choice in nearly 80% of cases, 6 but in this case of anastomotic recurrence, we selected radiation therapy due to the history of multiple open ureteral surgeries and the high degree of adhesion already present at the time of the previous surgery.…”

Section: Discussionmentioning

confidence: 93%

Control of bleeding from a recurrent tumor at a uretero‐ileal anastomosis by electrocoagulation via an ileal conduit

Yasujima,

Nakanishi,

Hirose

et al. 2023

IJU Case Reports

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IntroductionBladder cancer is characterized by spatial and temporal recurrence in the urinary tract. We describe a case of recurrence at a uretero‐ileal anastomosis after radical cystectomy and nephroureterectomy. It was difficult to control bleeding from the tumor, but hemostasis was achieved.Case presentationA 73‐year‐old man with a history of radical cystectomy and reconstruction of the ileal conduit and right nephroureterectomy was diagnosed with recurrence at the uretero‐ileal anastomosis site. Bleeding from the tumor could not be controlled by flexible gastrointestinal endoscopy. The patient underwent coagulation via an ileal conduit approach using a rigid scope and bipolar electrocautery, which is usually a modality for transurethral resection.ConclusionThis is the first report in which a modality normally used for transurethral resection was used to control bleeding in a patient with an ileal conduit. This application is useful in cases open surgery or additional irradiation might be difficult.

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Section: Discussionmentioning

confidence: 93%

Control of bleeding from a recurrent tumor at a uretero‐ileal anastomosis by electrocoagulation via an ileal conduit

Yasujima,

Nakanishi,

Hirose

et al. 2023

IJU Case Reports

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“…ABL1 on chromosome 9 undergoes mutual translocation with the BCR gene on chromosome 22 to make the Philadelphia chromosome, which is well known to cause chronic myelogenous leukemia [ 43 – 48 ]. There have been many studies on the breakpoint cluster region in which mutual translocation occurs in the ABL1 , and it has also been reported that many mutations and repeat sequences exist in the region [ 2 , 4 , 49 , 50 ]. Among the repetitive nucleotide sequences found in the human genome, nucleotide sequences such as LINE, SINE, LTR, and SSLP play an important role as a regulator of biological genome evolution and gene expression, and are reported as genetic causes of various diseases [ 16 – 20 ].…”

Section: Discussionmentioning

confidence: 99%

“…The Abelson murine leukemia virus oncogene homolog 1 ( ABL1 ) encodes a kinase and is activated by several switch kinases such as receptor tyrosine kinase ( RTK ) and cyclic AMP ( cAMP ), and is involved in various cellular processes including cell growth, division, differentiation and migration [ 1 ]. ABL1 presents at 9q34.12 on chromosome 9, translocate with the breakpoint cluster region (BCR) gene on chromosome 22 to form the Philadelphia chromosome, the cause of chronic myelogenous leukemia [ 2 ]. The BCR region present in ABL1 contains retrotransposon repeats, a DNA sequence that can be rearranged within the genome, and satellite DNA, a short repeat sequence.…”

Section: Introductionmentioning

confidence: 99%

VNTR polymorphism in the breakpoint region of ABL1 and susceptibility to bladder cancer

et al. 2021

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Background ABL1 is primarily known as a leukemia-related oncogene due to translocation, but about 2.2% of ABL1 mutations have been identified in bladder cancer, and high expression in solid cancer has also been detected. Methods Here, we used the NCBI database, UCSC genome browser gateway and Tandem repeat finder program to investigate the structural characterization of the ABL1 breakpoint region and to identify the variable number of tandem repeats (VNTR). To investigate the relationship between ABL1-MS1 and bladder cancer, a case-controlled study was conducted in 207 controls and 197 bladder cancer patients. We also examined the level of transcription of the reporter gene driven by the ABL1 promoter to determine if the VNTR region affects gene expression. Results In our study, one VNTR was identified in the breakpoint region, the intron 1 region of ABL1, and was named ABL1-MS1. In the control group, only two common alleles (TR13, TR15) were detected, but an additional two rare alleles (TR14, TR16) were detected in bladder cancer. A statistically significant association was identified between the rare ABL1-MS1 allele and bladder cancer risk: P = 0.013. Investigating the level of transcription of the reporter gene driven by the ABL1 promoter, VNTR showed inhibition of ABL1 expression in non-cancer cells 293 T, but not in bladder cancer cells. In addition, ABL1-MS1 was accurately passed on to offspring according to Mendelian inheritance through meiosis. Conclusions Therefore, the ABL1-MS1 region can affect ABL1 expression of bladder cancer. This study provides that ABL1-MS1 can be used as a DNA fingerprinting marker. In addition, rare allele detection can predict susceptibility to bladder cancer.

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“…The spatulated ureters and the conduit were connected by end-to-side anastomosis with a 3-0 absorbable continuous lock-stitch suture after the stoma was fixed to the skin. The ureters were dissected free as much as possible to achieve a tension-free ureteroileal conduit anastomosis [25]. A ureteral stent was placed before anastomosis and was removed after anastomosis.…”

Section: Methodsmentioning

confidence: 99%

An improved ileal conduit surgery for bladder cancer with fewer complications

Liu

Yao

et al. 2019

Cancer Communications

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Background Radical cystectomy and urinary diversion remains the standard surgical treatment for patients with muscle-invasive or high-risk or recurrent non-muscle-invasive bladder cancer. Although this approach prolongs patient survival remarkably, there are postoperative complications associated with urinary diversion. This study aimed to assess the efficacy of modified ileal conduit surgery for reducing early and late stoma- and ureteroileal anastomosis-related complications, as compared with conventional ileal conduit urinary diversion. Methods We retrospectively evaluated the clinical data of bladder cancer patients treated with radical cystectomy and ileal conduit urinary diversion at Sun Yat-sen University Cancer Center between January 1, 2000 and June 30, 2016. Ileal conduit was created by the conventional or a modified technique. The clinicopathologic features of the conventional and the modified ileal conduit groups were compared using the t test and the Chi square test. Multivariable logistic regression analysis and multivariable Cox regression analysis were performed to determine the odds of developing stoma- and ureteroileal anastomosis-related complications in the two groups. Results 145 and 100 patients underwent the modified and conventional ileal conduit surgery, respectively. The two groups were comparable with regard to clinicopathologic features. The rate of stoma-related complications was significantly lower in the modified ileal conduit group than in the conventional ileal conduit group (0.7% vs. 17.0%, P < 0.001). No late stoma-related complications were seen in the modified ileal conduit group, but were seen in 13 (13.0%) patients in the conventional ileal conduit group. The rate of ureteroileal anastomosis-related complications was significantly lower in the modified ileal conduit group than in the conventional ileal conduit group (4.8% vs. 15.0%, P = 0.001). In multivariable analyses, the modified ileal conduit group was significantly less likely to develop stoma- (odds ratio [OR] = 0.024, 95% confidence interval [CI] 0.003–0.235; P = 0.001) or ureteroileal anastomosis-related complications (OR = 0.141, 95% CI 0.042–0.476; P = 0.002) than the conventional ileal conduit group. Conclusions Our modified surgical technique for ileal conduit urinary diversion may be effective for reducing early and late complications related to the stoma and the ureteroileal anastomosis. Prospective randomized clinical trials are needed to confirm our results.

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Segmental ureteroileal conduit resection for the treatment of distal upper urinary tract recurrence of bladder cancer following cystectomy

Cited by 4 publications

References 22 publications

Control of bleeding from a recurrent tumor at a uretero‐ileal anastomosis by electrocoagulation via an ileal conduit

Control of bleeding from a recurrent tumor at a uretero‐ileal anastomosis by electrocoagulation via an ileal conduit

VNTR polymorphism in the breakpoint region of ABL1 and susceptibility to bladder cancer

An improved ileal conduit surgery for bladder cancer with fewer complications

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