Uretero‐intestinal anastomosis in low‐pressure reservoirs: refluxing or antirefluxing?

Ghoneim, Mohamed A.; Osman, Yasser

doi:10.1111/j.1464-410x.2007.07052.x

Cited by 17 publications

(9 citation statements)

References 77 publications

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“…Ghoneim et al . reported in their review that strictures occurred in 4.9–25% of Le Duc procedures versus 1.7–7% with direct ureterointestinal anastomosis, and reflux occurred in 3–19% of Le Duc procedures versus 1.5–100% with direct ureterointestinal anastomosis 11 . Kouba et al .…”

Section: Discussionmentioning

confidence: 98%

“…Originally ureteroileal anastomosis was performed by the end‐to‐side Nesbit method 10 . The mechanism for preventing ureteroileal reflux is considered to be bowel peristalsis of the afferent limb and the low‐pressure reservoir 11 . Hautmann et al .…”

Section: Discussionmentioning

confidence: 99%

“…10 The mechanism for preventing ureteroileal reflux is considered to be bowel peristalsis of the afferent limb and the low-pressure reservoir. 11 Accordingly, patients at a very early stage just after removal of the urethral catheter were considered to easily acquire ureteroileal reflux and pyelonephritis because of the smaller capacity of orthotopic ileal neobladder, therefore we had adopted the Le Duc anti-reflux ureteroileal anastomosis. However, the surgical technique for the Le Duc is more troublesome and takes longer to complete.…”

Section: Discussionmentioning

confidence: 99%

“…Ghoneim et al reported in their review that strictures occurred in 4.9-25% of Le Duc procedures versus 1.7-7% with direct ureterointestinal anastomosis, and reflux occurred in 3-19% of Le Duc procedures versus 1.5-100% with direct ureterointestinal anastomosis. 11 Kouba et al compared Bricker (separate) and Wallace (conjoined) direct ureteroenteric anastomosis patients and found 3.7% ureteroenteric anastomosis strictures in the Bricker cases versus none in the Wallace patients, revealing a statistically significant difference. 8 Our data revealed one case of ureteroileal anastomosis stricture in the Le Duc group resulting in a non-functioning kidney even though balloon dilation treatments were performed , although the two groups in our study were similar in terms of renal function, pyelonephritis, and the patients requiring CIC.…”

Section: Discussionmentioning

confidence: 99%

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Wallace direct versus anti‐reflux Le Duc ureteroileal anastomosis: Comparative analysis in modified Studer orthotopic neobladder reconstruction

et al. 2011

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Objectives: To investigate and compare Wallace direct ureteroileal anastomosis with Le Duc anti-reflux procedure in modified Studer orthotopic neobladder reconstruction after radical cystectomy. Methods: A total of 72 consecutive patients who underwent modified Studer orthotopic bladder reconstruction after a radical cystectomy for bladder cancer were investigated. They were examined for vesicoureteral reflux, hydronephrosis, and pyelonephritis at 6 months after surgery according to the type of ureteroileal anastomosis. Results: Vesicoureteral reflux occurred in 29 ureters (38.2%) after the Wallace procedure compared to six ureters (9.6%) with the Le Duc (P < 0.05). Hydronephrosis was detected in 12 ureters (18.8%) in the Le Duc patients compared to seven (9%) in the Wallace patients (P > 0.05). Six months after the operation, all three patients with vesicoureteral reflux-related hydronephrosis improved using clean intermittent catheterization in the Le Duc patients; five of seven patients were cured by clean intermittent catheterization and two improved without any treatment in the Wallace patients. Seven of nine cases of ureteroileal anastomosis stenosis causing hydronephrosis were cured without any treatment but one case resulted in a non-functional kidney despite treatment of the stenosis. Conclusions: Direct ureteroileal anastomosis using the Wallace method is effective for minimizing ureteroileal anastomosis stenosis and it represents a simple surgical procedure when combined with a modified Studer procedure.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Wallace direct versus anti‐reflux Le Duc ureteroileal anastomosis: Comparative analysis in modified Studer orthotopic neobladder reconstruction

et al. 2011

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“…Although limited analytical literature on Le Duc anastomotic technique exists, the stricture rate has consistently been reported as significantly higher [34,35]. Shigemura et al in 2012 evaluated 712 patients in which 32 had LeDuc and 39 had Wallace ureteral anastomosis who underwent a modified (N-shaped) Studer neobladder urinary diversion with a median follow-up of 29.5 months.…”

Section: Running Vs Interruptedmentioning

confidence: 97%

Urinary Diversion in the Elderly

Ayoub

Westney

2015

Curr Bladder Dysfunct Rep

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The elderly or older population segment has a heterogenous definition in the literature with the majority including patients aged between 60 and 80 years. Several studies have proven that a cystectomy can be performed safely in the elderly population. We sought out to review the literature identifying the specific complications and the considerations requiring attention when performing a urinary diversion on an elderly patient. A review of literature performed using PubMed revealed paucity of citations specifically looking at different urinary diversion techniques and the specific complications related in an elderly population. However, we extrapolated additional data from articles that studied cystectomy surgical cohorts with identifiable age stratification. Particular complications and areas deserving of additional attention included gastrointestinal, renal, ureteroenteric anastomotic technique, metabolic disorders, quality of life, and voiding dysfunction. Detailed history and proper counseling of the patient and family are central to the selection of the appropriate urinary diversion technique and help maintain realistic patient expectations with a higher satisfaction rate. It is of paramount importance when considering continent urinary diversions to address the feasibility of adhering to a higher level of maintenance and the patient's ability to withstand diversionrelated complications.

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