| Article ID | Journal | Published Year | Pages | File Type |
|---|---|---|---|---|
| 3997365 | Revista Colombiana de Cancerología | 2010 | 10 Pages |
ResumenObjetivoValorar la función renal y los efectos colaterales de la bolsa de Indiana como método quirúrgico.MétodoReporte de serie de casos de 75 pacientes operados desde junio de 1987 hasta junio del 2008 con bolsa de Indiana.ResultadosLos tumores incluyeron 36 cánceres de vejiga, 35 cánceres de útero, 2 melanomas vaginales, 1 cáncer de vulva y 1 osteoclastoma, La bolsa se usó en 35 cistectomÃas radicales y 14 exenteraciones pélvicas, y en 26 pacientes se hizo sin cirugÃa extirpativa tumoral. El 95% de pacientes mantuvo la función renal. Los electrolitos séricos permanecieron normales. La continencia completa se consiguió en 92% de los casos. La capacidad promedio del reservorio fue de 536,5 ml; 21 (25,8%) riñones sanos se perdieron al reimplantarse. Por otra parte, 22 (56,4%) riñones hidronefróticos llegaron a ser sanos. Complicaciones: temprana, 6,66%; tardÃa 46,0%. Reintervención: temprana, 8,0%; tardÃa 40,1%. Mortalidad perioperatoria 8,0%; mortalidad acumulativa, 45,30%. Supervivencia promedio: 30,7 meses.ConclusionesLa bolsa de Indiana es una derivación urinaria útil cuando no es factible preservar la uretra. Presenta más complicaciones tardÃas que tempranas. La hidronefrosis, el daño parenquimatoso y la neocistolitiasis fueron frecuentes en esta serie, con 48% de pacientes irradiados.
ObjectiveTo evaluate the renal function and side effects of the Indiana pouch at the National Cancer Institute of Colombia.Method75 cases with history of Indiana Pouch reconstructive surgery were recruited from June 1987 to June, 2008.Results36 bladder; 35 uterine cancer; 1 vulvar cancer, vaginal cancer, 2 melanomas; and 1 osteoclastoma were included. The Indiana Pouch was used in 35 radical cystectomies, and 14 pelvic exenterations. In 26 cases, there was non-surgical tumor extirpation. 95% of patients continued with proper renal function and normal serum electrolytes. Complete continence was in 92% of cases. The average reservoir capacity was 536.5ml; 22 (24.7%) healthy kidneys were lost after re-implantation. In contrast, 22 (56.4%) hydro-nephronic kidneys became healthy. Early complications were present in 6.66% of cases; and late complications in 46.70%. Early re-intervention was observed in 8.0%; late, 40.1%. Perioperative mortality was 8.0%; cumulative mortality, 45.3%. The average survival was 30.7 months.ConclusionsThe Indiana Pouch is a useful urinary device when urethra preservation is not possible. Complications occur late rather than early. Hydronephrosis, parenchymatic damage and neo-cystolytiasis were frequent in this series, wherein 48% of patients were irradiated.
