Açık ve Robot Yardımlı Laparoskopik Cerrahi ile Yapılan Ögmentasyon İleosistoplasti Sonrası Anastomoz Hattı Perfüzyonunun Floresan Moleküler Görüntüleme ile Değerlendirilmesi

Abstract

Objective: An important complication of the augmentation ileocystoplasty is bladder per - foration. Some authors have proposed that perforations result from ischemic necrosis in the bladder- bowel anastomotic sites. The aim of this study was to evaluate the tissue perfusion in the anastomotic suture line in augmentation ileocystoplasty performed with various techiques. Material and Methods: Four swines were used. The animals were divided into two groups, in pairs. In group 1, augmentation ileocystoplasty with U patch single-layer anstomosis (SLA) and U patch two-layer anastomosis (TLA) were performed by open surgery (OS). In group 2, the same procedures were performed with robot- assisted laparoscopic surgery (RALS). The perfusion of the bladder-ileum anastomotic line was eval - uated by photodynamic eye. Results: The median width of the ischemic zone in SLA was 5 mm (range 2-14 mm) in OS, and 3 mm (range 2-14 mm) in RALS. The median width of the ischemic zone in TLA was 13 mm (range 10-19 mm) in OS, and 8 mm (range 4-12 mm) in RALS. Conclusion: In aug - mentation ileocystoplasty, intraoperative evaluation of the ischemic zone in the anastomotic line by photodynamic eye is an effective and feasible method. Single or two-layer anastomosis, perfomed ei - ther by OS or RALS seems to be not causing significant change in the ischemic zones. However, long- term results of similar studies should be determined to show the role of ischemia in the etiology of bladder perforations after augmentation ileocystoplasty.