| Gastrointestinal function and metabolic control after construction of an orthotopic ileal neobladder in bladder cancer. | |
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MedLine Citation:
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PMID: 17366097 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: To investigate the effects of ileum resection in orthotopic neobladder construction on gastrointestinal function and metabolic control. MATERIAL AND METHODS: We included 28 patients who underwent radical cystectomy and construction of an orthotopic neobladder or continent ileal reservoir for bladder cancer. As controls, 10 patients endoscopically treated for non-invasive bladder cancer (TaG2) were enrolled. Gastrointestinal symptoms, enterohepatic bile salt circulation, gastric emptying and gastrointestinal hormones involved in metabolic control were monitored. RESULTS: Of the cystectomy patients, 25% experienced daily diarrhoea and faecal urgency due to bile acid malabsorption, compared to 0% of the controls (p = 0.013). The cystectomy patients experienced faster gastric emptying and had higher levels of peptide YY. Plasma concentrations of insulin, glucagon-like peptide-1 and glucose were unchanged. CONCLUSIONS: Using the distal ileum for orthotopic neobladder construction causes bowel disorders in a quarter of cystectomy patients. Diarrhoea and faecal urgency are probably caused by decreased reabsorption of bile and are not due to changes in gastrointestinal hormones. A sizeable proportion of patients develop bile salt-induced diarrhoea, which can be relieved by treatment with cholestyramine. |
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Authors:
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Andreas Thorstenson; Hans Jacobsson; Erik Onelöv; Jens Juul Holst; Per M Hellström; Anne-Charlotte Kinn |
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Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Scandinavian journal of urology and nephrology Volume: 41 ISSN: 0036-5599 ISO Abbreviation: Scand. J. Urol. Nephrol. Publication Date: 2007 |
Date Detail:
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Created Date: 2007-03-16 Completed Date: 2007-04-10 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0114501 Medline TA: Scand J Urol Nephrol Country: Sweden |
Other Details:
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Languages: eng Pagination: 14-9 Citation Subset: IM |
Affiliation:
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Department of Molecular Medicine, Section of Urology, Stockholm, Sweden. andreas.thorstenson@karolinska.se |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Artificial Organs* Bile Acids and Salts / blood Cystectomy Female Gastric Emptying* Glucagon-Like Peptide 1 / blood Humans Ileum / surgery* Male Middle Aged Peptide YY / blood Recovery of Function Urinary Bladder Neoplasms / surgery* Urinary Diversion* |
| Chemical | |
Reg. No./Substance:
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0/Bile Acids and Salts; 106388-42-5/Peptide YY; 89750-14-1/Glucagon-Like Peptide 1 |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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