[Long-term results of a series of 39 of Bordeaux-type bladder replacements using ileocecal grafts after total prostatectomy and cystectomy].
A series of 136 bladder replacements using colon tissue was performed after total prostacystectomy for cancer of the bladder. Sixty-four Bordeaux-type ileocecal replacements were performed. The first bladder Bordeaux-type was created in March 1985. The technique involves detubulization of an ileocecal segment using 15 cm of the right colonic segment submucally according to the Goodwin technique. Uretral anastomosis uses the lower most portion of the cecum. Ileocecal anastomosis is performed manually or using a biofragmenting ring with terminoterminal junction as in the last 12 patients. After a follow-up of 1 to 8 years, 39 patients were evaluated for long-term results. The notion of need was obvious. Daytime continence was achieved in all patients. Night-time continence was achieved in 75% including several patients who had nocturnal mictions. Bladder filling occurred at low pressure with peaks from 5 to 20 cm H2O. Bladder capacity varied from 300 to 400 cc. Mean urinary flow was 21 ml/s. No cases of diarrhea were observed. Radiotransparent and asymptomatic bladder stones were seen in two cases. Mean corpuscular volume, vitamin B12 and folic acid levels were normal in 3/4 patients. No cases of elevated chloride were observed and no cases of oxaliuria occurred. Bladder Bordeaux-type construction offers a functional volume similar to the normal bladder with good metabolic tolerance, remarkable good stability over time and no deterioration of the upper urinary system.
Le Guillou
M
M
C.H.U. Pellegrin, Service d'urologie, Hôpital Pellegrin-Tripode, Bordeaux.
Pariente
J L
JL
Ferrière
J M
JM
Allard
P
P
Maire
J
J
Hostyn
B
B
D002432:Cecum / Q000637:transplantation*; D015653:Cystectomy; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000637:transplantation*; D008297:Male; D011468:Prostatectomy; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000601:surgery*
Résultats à long terme d'une série de 39 remplacements vésicaux type vessie de Bordeaux par greffon iléo-caecal détubulisé après prostato-cystectomie totale.