Document Detail


Gastrointestinal function and metabolic control after construction of an orthotopic ileal neobladder in bladder cancer.
MedLine Citation:
PMID:  17366097     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
Andreas Thorstenson; Hans Jacobsson; Erik Onelöv; Jens Juul Holst; Per M Hellström; Anne-Charlotte Kinn
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Scandinavian journal of urology and nephrology     Volume:  41     ISSN:  0036-5599     ISO Abbreviation:  Scand. J. Urol. Nephrol.     Publication Date:  2007  
Date Detail:
Created Date:  2007-03-16     Completed Date:  2007-04-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0114501     Medline TA:  Scand J Urol Nephrol     Country:  Sweden    
Other Details:
Languages:  eng     Pagination:  14-9     Citation Subset:  IM    
Affiliation:
Department of Molecular Medicine, Section of Urology, Stockholm, Sweden. andreas.thorstenson@karolinska.se
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MeSH Terms
Descriptor/Qualifier:
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:
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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