Modified technique to prevent complications related to stoma and ileoureteral anastomosis in patients undergoing ileal conduit diversion

Urology
Zhi Ling ZhangXiao Feng Chen

Abstract

To introduce a modified technique for preventing complications related to stoma and ileoureteral anastomosis in patients undergoing ileal conduit diversion. A urinary stoma was created intracorporeally and was pulled out to the abdominal wall through a retroperitoneal tunnel. The ileal conduit was fixed by nonabsorbable sutures that incorporated all abdominal wall fascia and the bowel seromuscular layer. The terminal ureter was spatulated and anastomosed to the conduit in an end-to-side fashion by a continuous lock-stitch suture after stoma maturation and conduit fixation. A 24F multiorifice catheter was introduced into the ileal conduit as a stent, but a ureteral stent was not used. The peritoneum underlying the stoma was preserved intact, and the ureters and the conduit were completely extraperitonealized. A urine collection device was attached to the matured stoma immediately after surgery. The modified technique was used in 56 consecutive patients who underwent ileal conduit diversions. The median operative time was 327 minutes. No early complications, such as urine or intestinal leakage, occurred. Two patients, however, developed ileus. The median follow-up was 36 months. Forty-five patients survived disease-free, whereas ...Continue Reading

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Citations

Feb 7, 2015·Scandinavian Journal of Urology·Johan StyrkeLeif Israelsson
Apr 13, 2013·Surgical Laparoscopy, Endoscopy & Percutaneous Techniques·Lisa M Coughlin, Dennis P Orr
Apr 20, 2019·Cancer Communications·Zhiyong LiFangjian Zhou

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