Background: The creation of antireflux mechanism for ureteroileal anastomosis in a low- pressure pouch is controversial and benefits should be weighted by possible morbidity. Different techniques were used as antireflux to preserve the upper urinary tract. Aim of the Work: to evaluate a modification of the subserous extramural tunnel for non-refluxing uretero-ileal anastomosis in orthotopic diversion using Wallace technique in a single trough after 2-year-duration follow up in terms of uretero-ileal anastmosis stricture, reflux and urinary tract infections. Patients and Methods: In all, 100 patients underwent orthotopic urinary diversion after radical cystectomy. Inclusion criteria included age from 30 to 65 years old, negative positive urethral margin, serum creatinine less than 2 mg/dl and tumor stage T2-T3. Exclusion criteria were stricture urethra, single kidney and poor performance status. Patients were followed up by serum creatinine, pouchogram, renal ultrasound and intravenous pyelogram if serum creatinine below 1.5 mg/dl. Results: In all, 2 patients missed follow up and 98 patients were evaluable over 24 months. Mean serum creatinine raised from 1.16 preoperative to 1.20 after 2 years. Reflux has been detected in 3 patients while stricture has affected 3 patients. 9 patients had symptomatic urinary tract infections or being infected with organism other than E.coli that necessitated admission and parenteral antibiotics; three of which were advised to do clean intermittent catheterization. Conclusion: Combining serous-lined extramural tunnel and Wallace techniques is an effective technique and has a comparable result to the other antirefluxing techniques in terms of ureteroileal stricture, reflux and acute pyelonephritis.
Abdullah, H., Nassar, K., El Awady, H., & Abdel Fattah, S. (2019). ANTIREFLUX URETEROILEAL ANASTOMOSIS FOR ORTHOTOPIC ILEAL NEOBLADDER USING WALLACE TECHNIQUE IN A SINGLE TROUGH. Ain Shams Medical Journal, 70(10, 11 & 12), 729-734. doi: 10.21608/asmj.2019.101284
MLA
Hany Mostafa Abdullah; Karim Omar Nassar; Hossam Mohamed El Awady; Sherif Osama Abdel Fattah. "ANTIREFLUX URETEROILEAL ANASTOMOSIS FOR ORTHOTOPIC ILEAL NEOBLADDER USING WALLACE TECHNIQUE IN A SINGLE TROUGH". Ain Shams Medical Journal, 70, 10, 11 & 12, 2019, 729-734. doi: 10.21608/asmj.2019.101284
HARVARD
Abdullah, H., Nassar, K., El Awady, H., Abdel Fattah, S. (2019). 'ANTIREFLUX URETEROILEAL ANASTOMOSIS FOR ORTHOTOPIC ILEAL NEOBLADDER USING WALLACE TECHNIQUE IN A SINGLE TROUGH', Ain Shams Medical Journal, 70(10, 11 & 12), pp. 729-734. doi: 10.21608/asmj.2019.101284
VANCOUVER
Abdullah, H., Nassar, K., El Awady, H., Abdel Fattah, S. ANTIREFLUX URETEROILEAL ANASTOMOSIS FOR ORTHOTOPIC ILEAL NEOBLADDER USING WALLACE TECHNIQUE IN A SINGLE TROUGH. Ain Shams Medical Journal, 2019; 70(10, 11 & 12): 729-734. doi: 10.21608/asmj.2019.101284
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