Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
SHR Neuro Krebs Kardio Lipid Stoffw Microb
Izquierdo-Luna, JS; Norz, V; Bedke, J; Aufderklamm, S; Amend, B; Mischinger, J; Gakis, G; Stenzl, A; Rausch, S.
A Modified Neobladder Technique: The "I-Pouch" - Illustration of Surgical Approach and Tricks.
UROLOGY. 2021; 147(11): 318-318.
Doi: 10.1016/j.urology.2020.10.017
Web of Science
PubMed
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- Co-Autor*innen der Med Uni Graz
- Mischinger Johannes
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- Abstract:
- Various techniques for orthotopic neobladder (ONB) are currently used and have shown satisfactory oncological and functional outcomes.3 Among the relevant oncological and functional aspects for long-term follow up is the easy accessibility of the upper urinary tract in urinary diversion for endoscopic monitoring. In addition, variety exists in the amount of ileum needed to create a urinary reservoir. Depending on the ONB technique, up to 60 cm of ileum are required, and bowel dysfunction may be a consequence especially when the ileocecal valve is used for the urinary diversion. We previously reported the technique, functional and oncologic results of the I-pouch, a modified ONB made of 40 cm of ileum, combining an antirefluxive ureter implantation technique with easy access to the uretero-intestinal anastomosis.1,2 The present video is intended to illustrate key surgical steps and pitfalls during the procedure. The technique, surgical tips, and functional results in a as compared to a institutional control group receiving conventional Studer -Pouch-procedure are outlined. In a follow up series of 33 I-pouch and 23 S-pouch patients, there were no differences according to ONB type for 30-day major- (P = .33) and minor (P = 0.96) complication rates although 90-day major (P = 0.08) and minor (P = 0.08) complication rates tended to be associated with less complications in I-pouch patients. The I-pouch can be used for neobladder substitution providing easy access to the upper urinary tract, reduced demand of ileum length along with a complication profile not distinct from Studer neobladder formation. Copyright © 2020 Elsevier Inc. All rights reserved.