Τίτλος:
Evaluation of findings during re-exploration for obstructive ileus after
radical cystectomy and ileal-loop urinary diversion: insight into
potential technical improvements
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
OBJECTIVE To retrospectively evaluate the findings during re-exploration
for obstructive ileus after radical cystectomy (RC) and ileal conduit
diversion.
PATIENTS AND METHODS During a 12-year period, 434 patients who had RC
and ileal conduit diversion were retrospectively evaluated for the
diagnosis of early (<= 30 days after RC) or late abdominal
re-exploration. The operative reports of patients requiring a second
abdominal procedure were reviewed, evaluating in particular the reason
for small bowel obstruction (SBO). In addition, the type of
entero-enteric anastomosis and the retroperitonealization of the
uretero-enteric anastomosis were compared between patients who required
abdominal reexploration for SBO and those who did not.
RESULTS Abdominal re-exploration for SBO was necessary for 14 (3.2%)
and 32 (7.3%) patients in the early and late postoperative period,
respectively. The most common reasons for SBO were anastomotic
malfunction (1.4%) and malignant recurrence (2.8%). Adhesions were the
second most common cause leading to ileus in both periods (1.1% and
2.3%, respectively). When there was no retroperitonealization of the
uretero-enteric anastomosis, SBO occurred more often both early and late
(P = 0.06). Early anastomotic malfunction leading to SBO was more common
( but not statistically significant, P = 0.06) when the entero-enteric
anastomosis was hand-sutured end-to-end.
CONCLUSIONS Anastomotic malfunction, bowel adhesions and internal
hernias are responsible for SBO early after surgery. The above reasons,
in addition to malignant recurrence, are the most common reasons for SBO
in the late postoperative period.
Συγγραφείς:
Varkarakis, Ioannis M.
Chrisofos, Michalis
Antoniou, Nikolaos
and Papatsoris, Athanasios
Deliveliotis, Charalambos
Περιοδικό:
BJU international (Papier)
Λέξεις-κλειδιά:
bladder cancer; radical cystectomy; complications; ileus
DOI:
10.1111/j.1464-410X.2006.06644.x
