The gastroileoileal pouch: an alternative continent urinary reservoir for patients with short bowel, acidosis and/or extensive pelvic radiation.
We report on 6 patients who underwent a new type of continent urinary diversion: the gastroileoileal reservoir. These are a select group of patients who presented with the short bowel syndrome, acidosis, borderline diarrhea and/or severe pelvic radiation, which precluded the use of terminal ileum and the ileocecal segment. Considering these factors, and based on the different functional properties of the stomach as well as the need for a large reservoir, a segment of stomach and proximal ileum was used to construct the reservoir. Four patients have been followed for at least 6 months, with the longest followup being 12 months. Temporary dysphagia requiring hydrogen blockers developed in 1 patient. Results indicate excellent function of the continent urinary system, lack of metabolic complications, absent diarrhea and excellent patient tolerance. This procedure could be a useful alternative in some difficult clinical situations when continent urinary diversion is desirable.
Department of Surgery, University of South Florida, H. Lee Moffitt Cancer and Research Institute, Tampa 33612.
J L
JL
Lockhart
R
R
Davies
C
C
Cox
E
E
McAllister
M
M
Helal
T E
TE
Figueroa
D000138:Acidosis / Q000150:complications; D000328:Adult; D000368:Aged; D001746:Bladder Exstrophy / Q000150:complications / Q000601:surgery; D000075202:Contraindications; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D008297:Male; D008591:Meningomyelocele / Q000150:complications; D008875:Middle Aged; D010388:Pelvis / Q000528:radiation effects*; D012778:Short Bowel Syndrome / Q000150:complications; D013270:Stomach / Q000601:surgery; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects / Q000379:methods*