• 作者：O.A. Castillo^a ; ^b ; ^c ; ^{octavio.castillo@indisa.cl} ; R. Campos^a ; I. Vidal^a ; A. Foneró ; n^a ; G. Rubio^a ; E. Landerer^a ; ^b ; R. Gó ; mez^a
• 关键词：Neovejiga ortotó ; pica ; Cistectomí ; a radical ; Cá ; ncer vesical
• 刊名：Actas Urol贸gicas Espa帽olas
• 出版年：2011
• 期刊代码：pca37_02104806
• 类别：med
• 出版时间：May 2011
• 卷：35
• 期：5
• 页码：296-301
• 文件大小：323 K

Introduction

We describe the technique and present the preliminary results of the laparoscopic radical cystectomy technique with the extracorporeal creation of a 鈥測鈥?shaped ileal orthotopic neobladder using non-absorbable mechanical suture (Fontana).

Materials and method

We describe the technique step by step and we present a series of 15 patients that underwent this surgery between November 2005 and August 2009, with special emphasis on the duration of the surgery, urinary diversion time, intraoperative and postoperative complications, daytime and night time continence and the frequency of postoperative micturition.

Results

The mean follow-up of the series was 24 months (6-32). The mean duration of surgery was 280 (range 210-345) minutes and the mean urinary diversion time was 54.5 (range 40-75) minutes. There were no intraoperative complications and the average hospitalization time was 7 (range 5-15) days. During the follow-up, there were 5 late postoperative complications, 2 cases of urinary infection with good response to antibiotic treatment and 3 uretero-neovesical anastomosis strictures, which were treated with percutaneous balloon dilation, with a good functional result. No lithiasis was found in the neobladder. Complete daytime continence was obtained in 13/14 patients (92.9%) and complete night time continence in 6/14 (42.9%). One patient (6.7%) required clean intermittent self-catheterization as the patient did not micturate spontaneously.

Conclusions

The creation of a 鈥淵鈥?shaped ileal orthotopic neobladder using non-absorbable mechanical suture is a feasible, fast and safe technique and it provides promising functional results. Further follow-up is required to determine its long-term results.