| A new technique for creation of a sigmoid neobladder for urinary reconstruction: clinical outcome in 42 men. | |
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MedLine Citation:
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PMID: 12893329 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: To present the results of a new technique for construction of a sigmoid neobladder after radical cystectomy. METHODS: Forty-two men, 43 to 74 years of age (mean age 62 +/- 8), underwent radical cystectomy for invasive bladder cancer and had a sigmoid neobladder created using a modification of the standard ureterointestinal anastomosis with rotation of the reservoir. The mean follow-up of this retrospective study was 35 +/- 20 months (range 6 to 90). The blood chemistry was analyzed routinely during follow-up, and complications, continence, and voiding pattern were assessed at regular intervals. RESULTS: There were 21 early complications in 14 patients: persistent urinary leakage in 2; wound infection in 9; prolonged ileus in 4; leakage from the colonic anastomosis in 2; and pulmonary embolus in 2. One patient each had venous thrombus of the lower extremities and methicillin-resistant Staphylococcus aureus colitis. One patient died in the perioperative period of massive pulmonary embolus, yielding a mortality rate of 2.4%. Eleven late complications occurred in 9 patients. Stenosis of the ureterointestinal anastomosis developed in 2 of 82 anastomoses, stenosis of urethral anastomosis in 4, and neobladder-ureteral reflux in 1. A reservoir stone was found in 1 patient, and adenoma and adenocarcinoma of the reservoir occurred in 1 patient each. One patient developed symptomatic hyperchloremic metabolic acidosis, and routine electrolyte evaluation revealed a slight metabolic acidosis in 6 patients. Hypovitaminosis B(12) did not occur in any patients. Of the 42 patients, 40 could void volitionally without catheterization. Patient satisfaction on continence, by day and night, was 77.3% and 72.7%, respectively. The mean neobladder capacity and the mean residual urine volume was 375 +/- 116 mL (range 234 to 624) and 68 +/- 86 mL (range 4 to 365), respectively. CONCLUSIONS: The modified sigmoid neobladder provides satisfactory results after radical cystectomy. |
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Authors:
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Masato Fujisawa; Atsushi Takenaka; Sadao Kamidono |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Urology Volume: 62 ISSN: 1527-9995 ISO Abbreviation: Urology Publication Date: 2003 Aug |
Date Detail:
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Created Date: 2003-08-01 Completed Date: 2003-08-15 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0366151 Medline TA: Urology Country: United States |
Other Details:
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Languages: eng Pagination: 254-8 Citation Subset: IM |
Affiliation:
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Department of Urology, Kawasaki Medical School, Kurashiki, Japan. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Colon, Sigmoid / surgery* Cystectomy / adverse effects, methods* Follow-Up Studies Humans Male Middle Aged Postoperative Complications / etiology Reconstructive Surgical Procedures / adverse effects, methods* Recovery of Function / physiology Retrospective Studies Surgically-Created Structures / adverse effects, physiology* Treatment Outcome Urinary Bladder / physiology, surgery* Urinary Bladder Neoplasms / surgery Urinary Diversion / adverse effects, methods* Urinary Reservoirs, Continent / physiology Urodynamics / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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