Neovejiga ileal con doble chimenea. Anastomosis ureterointestinal

Benites, F. Aguirre; Ojeda, J.M. Duarte; Casamayor, M. Pamplona; González, Rosa María Álvarez; Galvis, Ó. Leiva

doi:10.1016/s0210-4806(05)73256-3

Cited by 2 publications

(1 citation statement)

References 13 publications

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“…This surgical modification seems to preserve ureteral vascularization, resulting to low stricture rate (4%). Additionally, in case of reintervention it is easier to access each anastomosis without damaging the other one [4]. We are using ureteral catheters on each side which are exteriorized to the skin and removed a week postoperatively.…”

Section: The Robotic Cystectomy and Two Chimney Approachmentioning

confidence: 99%

Robotic Orthotopic Neobladder: The Two Chimney Technique

Pardalidis¹,

Andriopoulos²,

Pardalidis³

2021

Modern Approach to Diagnosis and Treatment of Bladder Cancer

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Bladder substitution following radical cystectomy for urothelial cancer (transitional cell carcinoma) has become increasingly common and in many centers has evolved to become the standard method of urinary diversion. Orthotopic neobladder has been a commonly used option for urinary diversion since the 1980s. Advantages of this type of diversion are the ability to avoid an ostomy, voiding function similar to the native bladder, and improved cosmesis. Robotic intracorporeal neobladder creation has demonstrated similar outcomes to open technique and represents a promising minimally invasive diversion for the future. The Studer pouch is widely used nowadays, yet there are still some drawbacks. Therefore, we designed a technique that would offer an orthotopic ureteroileal anastomosis by using a two chimney modification. This modification is simple to handle, safe and free of ureteric stricture or reflux. With low stricture rates, this modified procedure of ureterointestinal anastomosis, is worthy of further promotion.

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Section: The Robotic Cystectomy and Two Chimney Approachmentioning

confidence: 99%

Robotic Orthotopic Neobladder: The Two Chimney Technique

Pardalidis¹,

Andriopoulos²,

Pardalidis³

2021

Modern Approach to Diagnosis and Treatment of Bladder Cancer

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Chimney Modification Technique for Ureterointestinal Anastomosis after Radical Cystectomy: Preliminary Evaluation of Short-Term Outcome and Impact on Quality of Life

Abdelwahab¹,

Ahmed

2010

Current Urology

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Objectives: To evaluate the short-term outcome of chimney modification technique of the Hautmann ileal neobladder for ureterointestinal anastomosis after radical cystectomy in cases of invasive bladder cancer. Patients and Methods: The study included 25 male patients with a mean age of 61.2 ± 6.6 years assigned for radical cystectomy. A neobladder reservoir was fashioned using an ileal loop in a W-shape with both ends not detubularized and used as chimneys of 3–5 cm for the afferent limb on each side for implantation of the 2 cm spatulated ureter into each side using the technique of end-to-end anastomosis. Patients were observed for early postoperative complications and ascending cystography was performed before catheter removal for assessment of reflux and pouch integrity. Postoperative follow-up assessment included evaluation of continence satisfaction, renal function was judged by estimation of serum creatinine and intravenous urography for evaluation of development of ureteric stricture. Quality of life (QoL) was assessed using the Quality of Life Questionnaire (QLQ-C30). Results: All patients passed a smooth intra-operative course with a mean operative time of 308 ± 53.2 minutes and mean intra-operative blood loss of 580 ± 175 ml. No mortality was reported, however, 3 patients had postoperative wound infection, another 3 patients had prolonged ileus for >48 hours and one patient developed neobladder leakage that was managed by prolonged uretheral catheterization for 5 weeks. Fourteen patients reported good continence for both day and night, 9 patients had good to satisfactory continence, while two patients had unsatisfactory continence. Postoperative serum creatinine levels were non-significantly higher compared to preoperative measurements. Urographic studies demonstrated no reflux or stricture in either of the implanted ureters, or hydronephrosis after 12-month followup. Throughout the first 6 months of follow-up, all patients showed progressive increase of total QoL score with a significant difference compared to that recorded at the first month post-operation and the mean 12-month collective score was improved by a mean score of 14.4 ± 5.4 than that of the first month post-operation. Conclusion: Chimney modification of the Hautmann neo-bladder after radical cystectomy is simple, safe and free of ureteric stricture or reflux. Also, the applied technique improved patient’s postoperative QoL.

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Neovejiga ileal con doble chimenea. Anastomosis ureterointestinal

Cited by 2 publications

References 13 publications

Robotic Orthotopic Neobladder: The Two Chimney Technique

Robotic Orthotopic Neobladder: The Two Chimney Technique

Chimney Modification Technique for Ureterointestinal Anastomosis after Radical Cystectomy: Preliminary Evaluation of Short-Term Outcome and Impact on Quality of Life

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