کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
3880341 1599030 2006 5 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
Changes in the Upper Urinary Tract After Radical Cystectomy and Urinary Diversion: A Comparison of Antirefluxing and Refluxing Orthotopic Bladder Substitutes and the Ileal Conduit
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی بیماری‌های کلیوی
پیش نمایش صفحه اول مقاله
Changes in the Upper Urinary Tract After Radical Cystectomy and Urinary Diversion: A Comparison of Antirefluxing and Refluxing Orthotopic Bladder Substitutes and the Ileal Conduit
چکیده انگلیسی

PurposeWe evaluated and compared the effects of different types of urinary diversion on functional and radiographic changes in the upper urinary tract.Materials and MethodsWe analyzed data on 275 patients who underwent radical cystectomy and urinary diversion for bladder cancer and were observed at least 12 months. Of the patients 197 received an orthotopic bladder substitute, including antirefluxing ureteral anastomoses in 111 (group 1) and refluxing ureteral anastomoses in 86 (group 2). Ileal conduits were created in 78 patients (group 3). Serial serum Cr, radiographic changes in the upper urinary tract after diversion and the number of episodes of APN were compared by diversion method. Mean followup was 52 months (range 12 to 174 months) with no difference among the groups.ResultsCompared with group 3 patients in groups 1 and 2 demonstrated a significantly higher incidence of moderate to severe hydronephrosis (p = 0.001) but the incidence was similar between groups 1 and 2 (6.3%, 8.3% and 1.4% of the renal units in groups 1 to 3, respectively). Stabilized postoperative Cr did not differ among the groups. CRF, defined as Cr 3.0 mg/dl or greater, occurred in 2.7% of the patients in group 1 and in 3.5% of those in group 2 but in none in group 3. APN was noted in 3.3%, 4.4% and 0.4% of patients in groups 1 to 3, respectively (p = 0.012).ConclusionsAn ileal conduit with a lower rate of diversion related hydronephrosis, CRF and morbidity associated with APN was superior to orthotopic bladder substitutes. Between the refluxing and antirefluxing types of orthotopic bladder substitutes no significant difference in functional or radiographic changes was noted.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: The Journal of Urology - Volume 175, Issue 1, January 2006, Pages 185–189
نویسندگان
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