Stapled and nonstapled tapered distal ileum for construction of a continent colonic urinary reservoir.
A continent colonic urinary reservoir was created in 10 patients who had undergone anterior exenteration for invasive bladder carcinoma. A tapered distal ileal segment with a catheterizable abdominal stoma provided full continence in all 10 patients. Tapering of the terminal ileum was achieved with a gastrointestinal anastomosis stapler in 5 patients or with a bowel clamp in 5 others. Three purse-string sutures of 2-zero silk were placed on the tapered ileal segment to increase the intraluminal pressure. A nontunneled ureterocolonic anastomosis was performed in all 20 ureters. No obstruction or reflux was noted in 19 ureters (95 per cent). Hydronephrosis at the anastomotic site was noted in 1 ureter and was successfully dilated percutaneously.
Bejany
D E
DE
Department of Urology, University of Miami School of Medicine, Florida.
Politano
V A
VA
D000328:Adult; D000368:Aged; D003106:Colon / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000000981:diagnostic imaging / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D013528:Surgical Staplers; D001743:Urinary Bladder / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000009:adverse effects / Q000379:methods*