Stone formation in Padua Ileal Neobladder performed with stapler

Pubblicato da il Mar 18, 2013 in | Commenti disabilitati su Stone formation in Padua Ileal Neobladder performed with stapler

==inizio abstract==

INTRODUCTION AND OBJECTIVES: With the advent of laparoscopic and robotic surgery, stapled neobladders, that were previously discouraged, are becoming a popular alternative to the traditionally constructed hand-sewn pouches. To date, few papers with adequate follow up reported the incidence of stone formation into stapled neobladders.
We reported the rate of stone formation in a 9-year experience of open orthotopic ileal neobladder performed with stapler.
METHODS: From October 2001 and March 2010, 401 consecutive patients, 351 males and 50 females, were treated with radical cystectomy and orthotopic Padua ileal neobladder for bladder cancer. Follow-up included a complete physical examination, serum electrolyte and creatinine assessment, urine analyses and urine culture at each visit, abdominal ultrasonography or CT scan alternatively at 6 month intervals. In case of stone formation into the ileal reservoir, patients underwent cystoscopy and if necessary transurethral lithotripsy.
RESULTS: Stones occurred into the neobladder in 34 patients (8.5%). Median follow up was 24 (IQR 3-162) months.
Median time to stone formation was 25 (IQR 5-108) months. Median serum creatinine level was 1.27 mg/ml (IQR 0.75-2.27). Five of these patients (14.7%) experienced also a stricture of neobladder-urethral anastomosis and underwent resection of exuberant tissue. Urinary tract infections occurred in 6 patients (17.6%) that were treated with antibiotics.
CONCLUSIONS: In our series of orthotopic Padua ileal neobladder performed through the use of stapler, the rate of stone formation is comparable with those reported in literature for completely hand sewn ileal reservoirs. Stone formation in a urinary diversion has a multifactorial cause; the use of stapler is a safety procedure because reduces operative time without impairing renal
function.

==fine abstract==