| Autor: |
Singh, P. B., Mohmood, Mufti, Tandon, Vipul, Rao, M. Prasada, Vyas, Nachiket, Nandy, P. R., Dutta, Biswajeet, Dwivedi, U. S. |
| Předmět: |
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| Zdroj: |
UroOncology; Mar2004, Vol. 4 Issue 1, p35-37, 3p, 4 Color Photographs |
| Abstrakt: |
Objective : To show the efficacy and ease of our modified technique of constructing orthotopic neo-bladder after radical cystectomy for carcinoma bladder. Materials and methods : A total number of 76 patients with invasive carcinoma of bladder underwent radical cystectomy and orthotopic neo-bladder construction at this tertiary care hospital. We modified the conventional Hautman's technique. In this we constructed the ileal pouch first on the abdominal surface after making a neo-urethra utilizing a "U" shaped flap of dependent ileal segment. Then at the end of the procedure, anastomosis is performed between the neo-urethra and the membranous urethra. These cases are followed up at regular intervals with usual protocols with special stress on uroflowmetry and complete urodynamic assessment in selected patients. Results : Out of 76 patients who had a follow up of more than 10 years, only 1 patient developed total incontinence, which developed early local recurrence. Day and night time continence rates were achieved in 95 and 90%, respectively. All patients have shown good urodynamic characteristics and normal upper tracts without vesicoureteral reflex. Conclusion : This new modified technique of making the pouch first on the surface with urethral anastomosis as a last step avoids accidental disruption, offers technical simplicity and substantially shorterns the operative time. This makes the procedure safer even in the hands of less experienced urologists without compromising continence rates. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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