Orthotopic double U-shaped ileal neobladder (report of 20 cases)
- VernacularTitle:双U形回肠代膀胱术的初步研究(附20例报告)
- Author:
Xiaohua YANG
;
Zhoujun SHEN
;
Ligang REN
- Publication Type:Journal Article
- Keywords:
Bladder neoplasms;
Carcinoma;
Total cystectomy;
Ileum;
Urinary diversion
- From:
Chinese Journal of Urology
2000;0(01):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To report the modified surgical technique currently used for the construction of an orthotopic ileal neobladder.So as to improve the vesical function of urinary storage and urination after total cystectomy. Methods Radical cystectomy and ileal neobladder with double “U” shape were performed in 20 patients with transitional cell carcinoma. After the detubularized ileal segment approximately 40 cm in length was arranged in a U configuration,the two medial borders of the U-shaped open segment were oversewn with a single layer seromuscular continuous 2-0 polyglycolic acid suture.The bottom of the U was folded over between the two ends of the U.Thus a spherical pouch, the neobladder, was fashioned. During that period, the neobladder anastomosed to the urethra.The ureters were implanted according to the improved stitching method. Results The operative time to form a neobladder was (90?15)min.Follow-up turned out that no perioperative or early postoperative mortality was observed, and no severe early complications occurred. The mean postoperative follow-up time was 25 (range,6 to 48) months.All the 20 cases achieved excellent continence except for 6 cases with temporary incontinence at night.Dysuria occurred in 1 case,and hydronephrosis on the left was found in 1 case.Six months later, the mean bladder capacity was 340 ml (range,250 to 450 ml). Conclusions The construction of an ileal neobladder using a smaller part of ileum that has been completely detubularized and fashioned by double U shape is easy and agreeable to perform.This mode of operation has low complication rates, achieves adequate capacity at low pressure, and provides satisfactory continence rates.
