scholarly journals Procena stepena bubrezne insuficijencije kod pacijenata podvrgnutih ilealnom konduitu kao vidu derivacije urina u odnosu na vrstu insercije uretera

2013 ◽  
Vol 60 (1) ◽  
pp. 53-60
Author(s):  
Z.M. Dzamic ◽  
B.M. Kajmakovic ◽  
T. Pejcic ◽  
B. Milkovic ◽  
M. Acimovic ◽  
...  
Keyword(s):  
Renal Function ◽  
Urinary Tract ◽  
Renal Insufficiency ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Daily Practice ◽  
Upper Urinary Tract ◽  
Intestinal Segment ◽  
Clinical Center

Ileal conduit as a form supravesical derivaton, is still one of most popular method of urinary diversion, in daily urological practice. Bearing in mind this fact, this type of diversion, rightfully so, is also called the "gold standard" in the derivation of urine. Considering the fact of unnatural route of elimination of urine from the upper urinary tract that occurs during creation of ileal conduit, it is reasonable to expect that, in time, this type of diversion lead to some degree of renal insufficiency. Some authors, this effect on renal function, attribute to specific type of ureterointestinal anastomosis during formation of ileal conduit1,2. A very important part of the surgical technique of creating ileal conduit is precisely a step of implantation ureters into the intestinal segment. The ultimate goal is to enable a more natural way of evacuation of urine from the upper urinary tract in terms of maintaining the quality of renal function. Numerous authors describes a quite number of techniques of ureteral implantation into the intestinal segment (Wallace A, Wallace B, Nesbit-Bricker, Le Duc ...)3,4. Each of these techniques has its own strengths and weaknesses, and the decision witch technique will be applied is still in the hand of urologist - operator, individually. Bearing in mind the fact of unnatural route of elimination of urine from the upper urinary tract that occurs during creation of ileal conduit, it is reasonable to expect that the renal function over the time will start to show signs of incipient or advanced failure 5,6,7,8. Objective: To determine the most appropriate type ureterointestinal anastomosis in forming ileal conduit, as a form of supravesical urinary diversion, to ensure adequate renal function postoperatively as an important parameter of quality of life. Methods and patients: This is a retrospective study, which covered a population of 193 patients treated at the Department of Urology, Clinical Center of Serbia, who underwent creation of ileal conduit as a form of urinary diversion. The study was conducted 2007. - 2011. Postoperative follow-up lasts up to 48 months. The assess of the level of renal insufficiency were analyzed by monitoring parameters which determine the degree of anemia, and biochemical parameters of renal function. We have investigated three techniques of insertion of the ureters into the ileal conduit, which are used in the daily practice (Wallace A, Wallace B, Nesbit-Bricker). Conclusion: Kidney failure occurs equally often in all patients who underwent urinary diversion by ileal conduit, ignoring the type of insertion of the ureters to the intestinal segment.

scholarly journals Procena stepena zastojnih promena na gornjim urinarnim putevima kod pacijenata podvrgnutih ilealnom konduitu kao vidu derivacije urina u odnosu na vrstu insercije uretera

2013 ◽  
Vol 60 (3) ◽  
pp. 17-24
Author(s):  
B.M. Kajmakovic ◽  
Z.M. Dzamic ◽  
T. Pejcic ◽  
B. Milkovic ◽  
M. Acimovic ◽  
...  
Keyword(s):  
Renal Function ◽  
Urinary Tract ◽  
Ileal Conduit ◽  
Upper Urinary Tract ◽  
Intestinal Segment ◽  
Physiological Level ◽  
Adequate Treatment ◽  
Renal Deterioration

Substitution of the bladder with segment of the digestive tract, within the radical treatment of bladder cancer, as well as treatment of the other bladder abnormality, is extremely demanding surgical procedure, that aims adequate treatment of the underlying disease and provide patient?s renal function within physiological level. Surgical implantation of the ureter into the intestinal segment are an important part of the surgical technique, the formation of ileal conduit, with the ultimate aim of providing a more natural way of evacuation of urine from the upper urinary tract in terms of maintaining the adequate quality of renal function. Which of the existing surgical method of implantation of ureter in the intestinal segment will be applied, it is for urologist to decided, according to his affinity and/or his operating school of origin. The literature describes many procedures of this technique (Wallace A, B Wallace, Nesbit-Bricker, Le Duc). Bearing in mind that the ileal conduit, as a form of supravesical derivation, is still one of most widely used method of urinary diversion, with a very large number of patients during the follow-up period were recorded certain complications of renal function disorders, which by some authors attributed to a type of ureterointestinal anastomoses, during the creation of ileal conduit. Having in mind the fact of unnatural route of elimination of urine from the upper urinary tract that occurs during creation of ileal conduit, it is reasonable to expect some degree of renal deterioration. These complications require prompt resolution. Bearing in mind the fact of unnatural route of elimination of urine from the upper urinary tract that occurs during creation of ileal conduit, it is reasonable to expect that the renal function over the time will start to show signs of incipient or advanced failure7. Objective: The main objective is to show the degree of renal deterioration, postoperatively, according to the type of insertion of the ureters to the ileal conduit. Methods and patients: The study was conducted retrospectively on material of Urological Clinic, Clinical Center of Serbia and on material of Faculty of Medicine, University of Belgrade, on 193 patients, for a period of five years (2007 to 2011), with a time of postoperative follow-up of patients up to 48 months (four years). Assessment of the level of renal deteriorisation was performed by ultrasound examination during regular audits of patients during follow-up. Conclusion: It was found that all three examed techniques in an insertion of ureter into ileal conduit were equally satisfactorily, with the similar degree of postoperative complications. Based on these facts, we can conclude, that the quality of life of patients in all three analyzed groups of ureteral insertion in the ileal conduit, approximately the same.

scholarly journals Renal function of bladder cancer patients after urinary diversion by ileal conduit in Rajavithi Hospital

2021 ◽  
Vol 42 (1) ◽  
pp. 34-39
Author(s):  
Sittichon Suriyawongkul ◽  
◽  
Chawawat Gosrisirikul ◽  
Vorapot Choonhaklai ◽  
Tanet Thaidumrong ◽  
...  
Keyword(s):  
Renal Function ◽  
Glomerular Filtration Rate ◽  
Urinary Tract ◽  
Glomerular Filtration ◽  
Filtration Rate ◽  
Estimated Glomerular Filtration Rate ◽  
Ileal Conduit ◽  
Upper Urinary Tract ◽  
Egfr Decline

Objectives: Our objectives were to evaluate the long-term renal function after radical cystectomy (RC) and ileal conduit diversion (ICD) and to analyze year-by-year the estimated glomerular filtration rate (eGFR) and morphologic upper urinary tract changes. Materials and Methods: We retrospectively identified 214 patients who had undergone RC and ICD from 2012 to 2018, with regular postoperative follow-up visits. The eGFR was calculated using the Modification of Diet in Renal Disease equation at baseline and during follow-up. A renal function decrease was defined as a greater than 10 mL/min/1.73 m2 reduction in the estimated glomerular filtration rate. Results: The median follow-up period after RC was 24 months (range, 6-60 months). The median eGFR decreased from 64 mL/min/1.73 m2 (range, 9-125 mL/min/1.73 m2) to 61.5 mL/min/1.73 m2 (range, 8-125 mL/min/1.73 m2). A decline in renal function occurred during the first postoperative years (2.74 mL/ min/1.73 m2 and 3.95 mL/min/1.73 m2 in the first and second year, respectively), with a slight decrease in the subsequent years. The strongest predictor of an eGFR decline was CKD stage 1 or 2 (> 60 mL/min/1.73 m2). Urinary obstruction was diagnosed in 6 patients (2.8%). Among the patients who underwent prompt interventional treatment, we did not find any association with the eGFR decline. Conclusion: Patients with urinary ICD have a lifelong risk of chronic kidney disease. Regular monitoring of renal function and the morphologic upper urinary tract will permit early diagnosis and treatment of modifiable factors, avoiding irreversible kidney damage.

Long-term effects of ileal conduit urinary diversion on upper urinary tract in bladder cancer

Urology ◽  
2006 ◽  
Vol 68 (2) ◽  
pp. 324-327 ◽  
Author(s):  
Won Jae Yang ◽  
Kang Su Cho ◽  
Koon Ho Rha ◽  
Hye Young Lee ◽  
Byung Ha Chung ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Urinary Tract ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Upper Urinary Tract ◽  
Long Term Effects

scholarly journals Quality of Life and Renal Functional Status In Patients With Cutaneous Ureterostomy and Ileal Conduit Urinary Diversion after Radical Cystectomy

2020 ◽  
Vol 23 (2) ◽  
pp. 142-150
Author(s):  
Subrata Deb ◽  
Md Golam Mowla Chowdhury ◽  
Mohammad Shafiqur Rahman ◽  
Mohammad Salahuddin Faruque ◽  
Ashraful Islam ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Function ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Group A ◽  
Muscle Invasive ◽  
Group B ◽  
Cutaneous Ureterostomy

Introduction: Radical cystoprostetectomy in male patients and anterior pelvic exenteration in female patients coupled with en-block pelvic lymphadenectomy and urinary reconstruction or diversion remains the gold standard surgical approach to muscle invasive bladder cancer in the absence of metastatic disease. In Bangladesh, commonly performed urinary diversions are Cutaneous ureterostomy and Ileal conduit. Types of urinary diversion have a great impact on different aspects of quality of life (QoL) as well as post -operative renal function. Aims and Objectives: This study was designed to compare the Quality of Life and Renal Function in between Cutaneous ureterostomy and Ileal conduit urinary diversion after radical cystectomy. Methodology: This was a hospital based Quasi Experimental study in which patients were selected by purposive sampling and, conducted from July, 2017 to September, 2018 in the department of Urology Bangabandhu Sheikh Mujib Medical University. This study was performed among the patients with muscle invasive bladder cancer treated by radical cystectomy with cutaneous ureterostomy or Ileal conduit fulfilling the exclusion and inclusion criteria. Total 34 patients were taken for the study, among them 17 for cutaneous ureterostomy and, 17 for Ileal Conduit Group. Quality of Life was assessed through EORTC-QLQ-C30 questionnaire both pre and post operatively (3 months after operation). Renal function was assessed before and 1st POD, 7thPOD, one month and three months after operation by measuring eGFR. Result: Mean age of the patients was 59.00 ± 8.60 years and 53.35 ± 8.43years in group- A (Cutaneous ureterostomy) and group-B (Ileal conduit) respectively. Three months after operation, overall QoL in all scales were improved in both group but, more improvements were noted in group-B than group-A which were statistically significant (p<0.05). The mean pre-operative eGFR was significantly lower in group-A than group-B (p<0.001). Three months after operation, statistically significant differences in eGFR, were observed within, and in between two groups (p<0.05). Percentage of eGFR changed (renal function deterioration) were significantly more in group-A than group-B (p=0.001). Conclusion: Quality of life, after radical cystectomy with ileal conduit is better than cutaneous ureterostomy and, post- operative renal function deterioration significantly less in ileal conduit group than cutaneous ureterostomy group. So, ileal conduit is an appropriate option of urinary diversion for the patient those who permit prolong operative procedure. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.142-150

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