New serosal lined antireflux ureteroileal implantation technique on a gia stapler detubularised ileal neobladder: technical considerations and results.
OBJECTIVE
To evaluate the adaptability and the possible advantages of the antireflux mechanism of the serous lined extramural tunnel for ureter re-implantation on a gastrointestinal anastomosis (GIA) Stapler detubularised ileal neobladder


METHODS
From April 1998 to July 2002 43 male patients underwent radical cystectomy and the creation of a Camey II ileal neobladder using this antireflux technique. Follow-up in all cases included excretory urography or T.C. scan and a retrograde cystography at 6 months and a renal scintigraphy with DMSA at 1 year follow-up, besides serum creatinine, blood urea and serum electrolytes every three months and renal-neovesical ultrasound every six months.


RESULTS
Early and late complications were low. At follow-up 1 case of neovesico-ureteral reflux and 2 cases of ureteroileal anastomotic strictures were found. DMSA scintigraphy showed no further renal scars.


CONCLUSIONS
This preliminary experience was favourable due to overall reduced operating time (about 1 hour 45 minutes to create the orthotopic neobladder and the ureteroileal anastomosis), simplicity of execution and a low complication rate (6.9%) at a median follow-up of 38 months (range 12-52 months).
Muto
Giovanni
G
Department of Urology, S.Giovanni Bosco Hospital, Piazza Donatori Sangue, 3, Torino 10154, Italy. g.muto@tin.it
Bardari
Franco
F
D'Urso
Leonardo
L
D000368:Aged; D000714:Anastomosis, Surgical; D015653:Cystectomy; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000033:anatomy & histology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019651:Plastic Surgery Procedures / Q000379:methods*; D012704:Serous Membrane / Q000033:anatomy & histology*; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent; D014718:Vesico-Ureteral Reflux / Q000517:prevention & control