1258 A COMPARISON OF HAND-SEWN AND STAPLED W ILEAL RESERVOIR FOR ORTHOTOPIC BLADDER REPLACEMENT

Abstract

You have accessJournal of UrologyUrinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion (I)1 Apr 20131258 A COMPARISON OF HAND-SEWN AND STAPLED W ILEAL RESERVOIR FOR ORTHOTOPIC BLADDER REPLACEMENT Luigi Cormio, Vincenzo Pagliarulo, Giuliano Ciavotta, L Paccione, Oscar Selvaggio, E Chiarulli, Arcangelo Pagliarulo, and Giuseppe Carrieri Luigi CormioLuigi Cormio Foggia, Italy More articles by this author , Vincenzo PagliaruloVincenzo Pagliarulo Bari, Italy More articles by this author , Giuliano CiavottaGiuliano Ciavotta Foggia, Italy More articles by this author , L PaccioneL Paccione Bari, Italy More articles by this author , Oscar SelvaggioOscar Selvaggio Foggia, Italy More articles by this author , E ChiarulliE Chiarulli Bari, Italy More articles by this author , Arcangelo PagliaruloArcangelo Pagliarulo Bari, Italy More articles by this author , and Giuseppe CarrieriGiuseppe Carrieri Foggia, Italy More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.2612AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Orthotopic bladder replacement (OBR) following radical cystectomy (RC), the treatment of choice for muscle-invasive bladder cancer, has gained increased popularity over the last two decades. Nevertheless, the complexity of the procedure and the additional surgical time needed for its creation continue to limit its routine use. METHODS Data of consecutive patients with invasive bladder cancer treated with RC and ORB at two university hospitals between December 2009 and June 2011 were prospectively collected and compared according to construction modality of W ileal reservoir, namely hand-sewn (Group/hospital 1) or stapled (Group/hospital 2). In both cases, approximately 50 cm of terminal ileum were used, with an approximate length of 15 cm for the 2 lateral arms and 10 cm for the 2 medial arms. The 4 arms were then detubularised and hand-sewn in Group 1 or stapled with 10 cm metallic GIA linear stapler in Group 2. In both cases the proximal and distal 5 cm of the harvested ileum remained not-detubularised and such horns of the neobladder were used for end-to-end uretero-ileal anastomosis. Time of reservoir construction and complications occurring up to 3 months postoperatively were analyzed. RESULTS Group 1 and Group 2 consisted of 10 and 11 patients, respectively. Mean time for reservoir construction was 6 min in Group 1 vs. 47 min in Group 2 (p<0.001). There were two cases of leakage from uretero-ileal anastomosis, one in each group, treated conservatively in Group 1 and by 6-weeks ureteric stenting in Group 2. There were no infective complications nor urinary stones in both groups. CONCLUSIONS The stapled reservoir provided the same results of the hand-sewn reservoir with a significant reduction in surgical time. The safety, ease and speed of the stapled technique may help expanding the indication to OBR after RC. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e515 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Luigi Cormio Foggia, Italy More articles by this author Vincenzo Pagliarulo Bari, Italy More articles by this author Giuliano Ciavotta Foggia, Italy More articles by this author L Paccione Bari, Italy More articles by this author Oscar Selvaggio Foggia, Italy More articles by this author E Chiarulli Bari, Italy More articles by this author Arcangelo Pagliarulo Bari, Italy More articles by this author Giuseppe Carrieri Foggia, Italy More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...