PD11-07 SLOW WAVE CONDUCTION DISTURBANCES PROXIMAL AND DISTAL TO ILEAL END-TO-END ANASTOMOSIS FOLLOWING ILEOCYSTOPLASTY

Abstract

You have accessJournal of UrologyUrinary Diversion: Bladder Reconstruction, Augmentation, Substitution, Diversion II1 Apr 2015PD11-07 SLOW WAVE CONDUCTION DISTURBANCES PROXIMAL AND DISTAL TO ILEAL END-TO-END ANASTOMOSIS FOLLOWING ILEOCYSTOPLASTY Fayez Hammad, Wim Lammers, John Rietbergen, Betty Stephen, and Loay Lubbad Fayez HammadFayez Hammad More articles by this author , Wim LammersWim Lammers More articles by this author , John RietbergenJohn Rietbergen More articles by this author , Betty StephenBetty Stephen More articles by this author , and Loay LubbadLoay Lubbad More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1096AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES End-to-end intestinal anastomosis is routinely performed in the course of managing several intestinal pathological conditions but there is no information regarding possible short- or long-term effects of such a procedure on the conduction of the electrical impulses in the vicinity of the anastomosis except for the fact that the slow wave will no longer propagate across the anastomosis. In the course of an ileocystoplasty project, we accidently discovered the presence of major conduction abnormalities of the slow wave in the region of the anastomosis following the surgery. METHODS In a rat model (n=8) of ileocystoplasty, an approximately 1 cm segment of terminal ileum was isolated (6-10 cm proximal to the cecum) and anastomosed to the bladder. The intestinal continuity was restored by an ileal end-to-end anastomosis and the animals were allowed to recover. After 1 day, 1 week or 1 month, the rats were again anaesthetized and the intestinal segment containing the anastomosis was isolated and positioned in a tissue bath where it was perfused with Tyrode. A 121-electrode array (11x11; 1 mm inter-electrode distance) was positioned at several locations proximal and distal to the anastomosis and recordings were performed from all 121 electrodes simultaneously. After the experiments, the signals were analyzed and propagation maps of the slow wave constructed RESULTS One day post-operatively, there was no slow wave propagation in the peri-anastomotic area (>5 cm proximal and distal to the anatomosis). After one week, the quiescent area was reduced, especially proximal to the anastomosis and had disappeared after 1 month. In the absence of the slow waves, multiple spikes were often seen at higher frequencies than normal. The distal segment still showed conduction disturbances 1 month after surgery CONCLUSIONS End-to-end ileal anastomosis is followed by a relatively long period of absence of slow waves and the appearance of other electrical impulse propagation abnormalities which might explain the post-operative local paralytic ileus and the potential pseudo-obstruction related to it © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e253 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Fayez Hammad More articles by this author Wim Lammers More articles by this author John Rietbergen More articles by this author Betty Stephen More articles by this author Loay Lubbad More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...