Laparoscopic-assisted radical cystectomy with U-shaped orthotopic ileal neobladder constructed using nonabsorbable titanium staples

Abreu, Sidney C.; Araújo, Mardhen B.; Silveira, Rômulo Augusto da; Regadas, Rommel Prata; Pinheiro, Danilo G.; Messias, Frederico I.; Argollo, Renato S.; Guedes, Glauco A.; Gadelha, J. B.; Fonseca, Gilvan N.

doi:10.1016/j.urology.2006.02.011

Cited by 17 publications

(15 citation statements)

References 14 publications

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“…These results are in accordance with the data reported by Abreu et al (5,6). However, small stones were found in 4(26%) of 17 patients.…”

Section: Discussionsupporting

confidence: 93%

“…Therefore, we agree that calculi formation in neobladder might be explained by another cause, including metabolic changes and other processes that take place in the pouch (13,14). Although the rates of stone formation in our study were a little bit higher than those previously reported (5,6,13,15,16), we believe that long-term follow--up and relative frequent endoscopic control might explain this discrepancy.…”

Section: Discussioncontrasting

confidence: 50%

“…Since the first report of successful laboratory and clinical data of stapled bladder closure with titanium staples (1), several studies have adopted this technique with encouraging results (2)(3)(4)(5)(6). This technique possesses several advantages, such as decreased operative time, excellent tissue adaptation and presumably watertight closure.…”

Section: Introductionmentioning

confidence: 99%

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605 Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples – long term follow-up

Kravchick¹,

Lobic²,

Paz³

et al. 2012

European Urology Supplements

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Purposes:We retrospectively assessed our experience with the W-shaped orthotopic ileal pouch, which was constructed with non -absorbable titanium staples. For these purpose, we discuss the results of bladder capacity, urinary continence and early and long-term postoperative complications. Materials and Methods:We included in the study 17 patients who underwent radical cystoprostatectomy followed by construction of an orthotopic W-shaped ileal pouch between October 2000 and November 2009. A 65-70 cm segment of ileum was isolated and prearranged into a W-configuration, leaving two 10 cm intact segments on both sides of the ileal fragment. In our technique we entirely anatomized all adjacent limbs in order to create a sphere-shaped pouch. The ureters were directly anastomized to both intact segments of the ileal division. All our patients underwent pouchscopy 6 months after operation and annually. Results: Mean operative time for neobladder reconstruction and ureteral anastomoses was 87 ± 7.67 minutes. In one patient a leak from the ileo-ileal anastomosis was confirmed on the 3rd day after operation. In 2 cases unilateral stricture of the ureteral-neobladder anastomosis was documented. Staple lines were mostly covered with ileal mucosa after 6 months. The mean functional bladder capacity was 340 ± 27.6 mL and 375 ± 43.4 mL at 6 and 12 months, respectively. First-year daytime and nighttime continence was good and acceptable in 90% and 78% of patients, while it increased to 95% during the 2nd year. Conclusions: The long term follow-up shows that non-absorbable titanium staples can be safely used for creation of an orthotopic ileal neobladder. However, these data should be further validated in a larger series of patients.

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“…These results are in accordance with the data reported by Abreu et al (5,6). However, small stones were found in 4(26%) of 17 patients.…”

Section: Discussionsupporting

confidence: 93%

Section: Discussioncontrasting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

605 Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples – long term follow-up

Kravchick¹,

Lobic²,

Paz³

et al. 2012

European Urology Supplements

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show abstract

“…They concluded that urinary diversion should be not performed in patients with two or more risk factors. Perhaps a preoperative metabolic evaluation should be performed to identify those patients at greater risk of stone disease to exclude them from the option of nonabsorbable staples for urinary diversion [15,29]. …”

Section: Resultsmentioning

confidence: 99%

Use of Nonabsorbable Staples for Urinary Diversion: A Step in the Wrong Direction

Suriano

Daneshmand²,

Buscarini

2012

Urol Int

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Background: The use of bowel segments incorporated into the urinary tract is well established in urological surgery. Objective: To describe and compare the use of absorbable and nonabsorbable staples for creation of a urine reservoir after radical cystectomy. Materials and Methods: This review is based on a systematic Medline search assessing the period 1950-2010. Results: Use of the autosuture stapling device for the construction of the urinary diversion significantly reduces operating time. Johnson and Fuerst reported its use for the first time to construct a ureteroileocutaneous urinary diversion in 1973. However, many studies demonstrated that exposed metal staples represent a nidus for stone formation when they are in direct contact with urine, particularly in urinary diversions such as Kock pouch and ileal conduit. Stone formation has been attributed in part to the use of nonabsorbable artificial materials, such as metal staples and Marlex mesh, strictures of the pouch and accumulation of mucus. The treatment options for pouch calculi include observation for spontaneous passage, extracorporeal shockwave lithotripsy, percutaneous or endoscopic lithotripsy/lithotomy. Conclusions: Historically, the mean time to stone formation with nonabsorbable material (staples, Marlex mesh) is 34 months. None of the studies on use of nonabsorbable staples in urinary diversion has such a long follow-up. Until further studies with more appropriate observation time are completed, the use of nonabsorbable staples for continent and noncontinent urinary diversion should be discouraged.

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“…Tampoco existe limitación para la realización de neo-vejigas ortotópicas. Abreu y col 20 , reportaron la realización extracorpórea de una neovejiga ortotópica ileal en forma de "Y" usando sutura mecánica no reabsorbible. Los autores presentaron su experiencia inicial con tres pacientes con excelentes resultados.…”

Section: Discussionunclassified

Cistectomía radical laparoscópica: técnica y resultados en 100 pacientes consecutivos

Vidal-Mora²

2013

Rev Chil Cir

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Radical laparoscopic cystectomy. Experience in 100 patientsBackground: Laparoscopic cystectomy is a less invasive alternative than traditional surgery. Aim: To report our experience with laparoscopic radical cystectomy, the technique, results and complications. Material and Methods: During a 10-year period, 100 consecutive laparoscopic cystectomies for bladder cancer were carried out. The procedures performed were 57 radical cystoprostatectomies, 27 pelvic exenterations, 14 cystectomies with prostate preservation and seven radical cystectomies. An extracorporeal urinary diversion was performed in 92% of cases. Results: The age of patients ranged from 29 to 83 years and the male/female ratio was 3:1. As urinary diversion, an orthotopic reservoir was used in 49 patients, and ileal conduit in 32, Indiana continent reservoir in 10 and intracorporeal Sigma-rectum pouch (Mainz pouch II) in 9 patients. All Mainz II pouches were constructed laparoscopically. Mean operative time and blood loss were 279 minutes (range 180 to 375) and 436 ml (range 50 to 1.500) respectively. Eight patients (11%) had perioperative complications: five had vascular lesions, two had eviscerations and two had septicemia. Delayed complications were observed in seven cases (9%). Three patients had a urinary sepsis, one had a ureteral stenosis, two had spontaneous ruptures of a continent reservoir and one had an intestinal fistula. Mean hospital stay was 8.8 days (range de 4 to 28). One patient died due to an intestinal fistula and secondary peritonitis. Mean followup was 18 months (range 2 to 68 months). Ten patients (13%) had disease progression and died in long-term follow up. Conclusions: Laparoscopic radical cystectomy is associated with a reduced operative bleeding, a short hospital stay and acceptable morbidity.

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Laparoscopic-assisted radical cystectomy with U-shaped orthotopic ileal neobladder constructed using nonabsorbable titanium staples

Cited by 17 publications

References 14 publications

605 Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples – long term follow-up

605 Radical cystectomy with W-shaped orthotopic ileal neobladder constructed with non-absorbable titanium staples – long term follow-up

Use of Nonabsorbable Staples for Urinary Diversion: A Step in the Wrong Direction

Cistectomía radical laparoscópica: técnica y resultados en 100 pacientes consecutivos

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