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. 2011:2011:431951.
doi: 10.5402/2011/431951. Epub 2011 Sep 14.

A novel antireflux technique for orthotopic ileal bladder substitutes-flat-segment technique: preliminary results

Hany Elfayoumy  1 , Ashraf Abou-Elela, Tamer Orban, Ashraf Emran, Mohamed Elghoneimy, Ahmed Morsy
Affiliations

A novel antireflux technique for orthotopic ileal bladder substitutes-flat-segment technique: preliminary results

Hany Elfayoumy et al. ISRN Urol. 2011.

Abstract

Objective. Although a large debate exists regarding the need for reflux prevention in ileal orthotopic neobladders, it is our policy to continue performing nonrefluxing ureteroileal anastomoses for our patients. An ideal uretero-ileal anastomosis must be simple, nonrefluxing, as well as non-obstructive. Here, we present a new antireflux mechanism for orthotopic ileal neobladders. Methods. 12 radical cystectomy patients for muscle invasive bladder cancer were candidates for orthotopic urinary diversion and underwent a non-refluxing uretero-ileal anastomosis using the flat-segment technique with a follow up of 6 to 18 months. Results. Preliminary results after the short-term followup showed that the success rate in reflux prevention was 92% and no cases of obstruction. The upper tracts were preserved or improved in all 12 patients. Operative time for neobladder creation ranged between 120-240 minutes, with a mean of 165 minutes (±36 minutes). No diversion-related complications. Conclusions. Based on our early data, we believe that the flat-segment uretero-ileal anastomosis technique for reflux prevention in orthotopic ileal bladder substitutes is simple, easy to learn and carries no additional morbidity to a standard refluxing uretero-ileal anastomosis, but has the advantage of effective reflux prevention. A longer follow-up period study with more patient numbers is ongoing.

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Figures

Figure 1
Figure 1
Steps for creation of the bladder substitute with the flat-segment valve technique.
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Figure 5
See this image and copyright information in PMC

References

    1. Libertino JA, Studer UE. Continent urinary diversions and neobladders in urologic surgery. In: Proceedings of the 95th AUA Annual Meeting; 1997; New Orleans, La, USA. Instructional Course.
    1. Stenzl A. Bladder substitution. Current Opinion in Urology. 1999;9(3):241–245. - PubMed
    1. Le Duc A, Camey M, Teillac P. Antireflux uretero-ileal implantation via a mucosal sulcus. Annales d’Urologie. 1987;21(1):33–34. - PubMed
    1. Shaaban AA, Gaballah MA, El-Diasty TA, Ghoneim MA, Sagalowsky AI, Skinner DG. Urethral controlled bladder substitution: a comparison between the intussuscepted nipple valve and the technique of Le Duc as antireflux procedures. Journal of Urology. 1992;148(4):1156–1161. - PubMed
    1. Abol-Enein H, Ghoneim MA. Further clinical experience with the ileal W-neobladder and a serous-lined extramural tunnel for orthotopic substitution. British Journal of Urology. 1995;76(5):558–564. - PubMed

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