| Revista: | International braz j urol |
| Base de datos: | PERIÓDICA |
| Número de sistema: | 000434620 |
| ISSN: | 1677-5538 |
| Autores: | Kavaric, Petar1 Eldin, Sabovic1 Nenad, Radovic1 Dragan, Pratljacic1 Vukovic, Marko1 |
| Instituciones: | 1Clinical Center of Montenegro, Department of Urology, Ljubljanska, Podgorica. Montenegro |
| Año: | 2020 |
| Periodo: | May-Jun |
| Volumen: | 46 |
| Número: | 3 |
| País: | Brasil |
| Idioma: | Inglés |
| Tipo de documento: | Artículo |
| Enfoque: | Analítico, descriptivo |
| Resumen en inglés | Purpose: To compare perioperative outcomes, complications and anastomotic stricture rate in a contemporary series of patients who underwent open radical cystectomy (RC) with modified Wallace anastomotic technique versus traditional ileal conduit. Materials and methods: Study enrolled 180 patients, of whom 140 were randomized and underwent RC; seventy were randomized to group I and the seventy to the group II. For the primary objective, we hypothesized that the rate of ureteroenteric strictures would be at least 20 % lower in the second group. Secondary end points included rate of anastomotic leak, surgical time, deterioration of the upper tract, intraoperative blood loss and patient-reported quality of life (HRQOL). The modified Wallace 1 technique involved eversion of the ureteral plate and bowel mucosa edges, which were anastomosed together in running fashion, while the outher anastomotic wall was augmented with sero-serosal interrupted sutures. Results: The mean (SD) follow-up time was 26.1 (5.7) months in group I and 25.2 (4.8) months in group II, during which, anastomotic stricture was observed in 8 patients (12%) from the first and 2 patients (3%) from the second group (p < 0.05). The anastomotic leakage rate was significantly higher in first group (17% vs. 8.5%, p< 0.05), while patient-reported HRQOL outcomes were similar between groups after the 12 month follow-up period. Conclusions: By using a modified Wallace technique, we were able to significantly lower anastomotic stricture and anastomotic leakage rates, which are major issues in minimizing both short- and long-term postoperative complications |
| Disciplinas: | Medicina |
| Palabras clave: | Urología, Cirugía, Cistectomía, Derivación urinaria, Técnicas quirúrgicas, Estenosis ureteroentérica, Anastomosis |
| Keyword: | Urology, Surgery, Cystectomy, Surgical techniques, Urinary Diversion, Anastomosis, Ureteroenteric stricture |
| Texto completo: | Texto completo (Ver HTML) Texto completo (Ver PDF) |
