A preliminary study on reducing the formation of intra-abdominal hernia and postoperative intestinal obstruction in laparoscopic Bricker operation
10.3969/j.issn.1009-8291.2023.11.002
- VernacularTitle:减少腹腔镜Bricker术中腹内疝形成与术后肠梗阻发生的临床观察
- Author:
Haoqiang SHI
1
;
Wenxiu HAN
2
;
Jun ZHOU
1
;
Sheng TAI
1
;
Cheng YANG
1
;
Zihui ZOU
1
;
Shuiping YIN
1
;
Yangyang ZHANG
1
;
Lingfan XU
1
;
Changsheng ZHAN
1
;
Guangjie JI
1
;
Chaozhao LIANG
1
Author Information
1. Department of Urology, The First Affiliated Hospital of Anhui Medical University/Institute of Urology, Anhui Medical University/Anhui Province Key Laboratory of Genitourinary Diseases, Anhui Medical University, Hefei 230022
2. Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, China
- Publication Type:Journal Article
- Keywords:
laparoscope;
Bricker;
internal abdominal hernia;
intestinal obstruction
- From:
Journal of Modern Urology
2023;28(11):923-927
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To reduce the incidence of postoperative intestinal obstruction, we tried to improve surgical techniques by closing the cavity formed during radical cystectomy + ileal passage (Bricker) via laparoscopy to prevent the formation of abdominal hernia. 【Methods】 During Oct.2018 and Feb.2022, 41 patients were involved (conventional group). After standard laparoscopic radical cystectomy + pelvic lymphadenectomy, the ileum channel was established. The right medial retroperitoneum was sutured to cover the mesothelium and end of the ileum channel under open operation or endoscope. The space between the ureter and mesothelium of the ileum channel was sealed, and the end of the ileum channel and both ureters were externalized. During Feb.2022 and Dec.2022, 15 patients were involved (modified group). The right inner and outer lateral peritoneums below the ileal conduit were sutured to "bottom out" the gap between the ileal conduit and the right abdominal wall in addition to standard procedures. The recovery of intestinal function and incidence of bowel obstruction were compared between the two groups. 【Results】 In the conventional group, the intestinal function recovered within 2 to 6 days after surgery, with a median ventilation time of 3 days. Intestinal obstruction occurred in 3 patients, 2 of whom improved after conservative treatment while 1 underwent surgical exploration after ineffective conservative therapy. There were no significant differences in the time of discharge and ventilation between the two groups, but no intestinal obstruction occurred in the modified group. 【Conclusion】 Peritoneal externalization at the end of ileal passage can reduce the incidence of intra-abdominal hernia and postoperative intestinal obstruction, which is worthy of clinical application.
