scholarly journals Uretero-intestinal anastomoses: which method to choose? History, current state of the issue and own experience

2021 ◽  
Vol 14 (1) ◽  
pp. 108-113
Author(s):  
P.V. Nesterov ◽  
◽  
A.V. Ukharskiy ◽  
E.V. Gurin ◽  
E.A. Metelkova ◽  
...  
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Anastomotic Stricture ◽  
Intestinal Anastomosis ◽  
Low Frequency ◽  
Functional Results ◽  
Early Postoperative Period ◽  
Long Term Results ◽  
Intestinal Anastomoses

Introduction. At the moment, after performing a cystectomy, one of the most urgent issues remains the choice of technique for performing uretero-intestinal anastomoses. Materials and methods. The search of the information was conducted in the Pubmed and Scopus databases, with a scientific electronic library Elibrary.ru and websites of professional urological and oncological associations. The search was performed for the keywords «Radical cystectomy», «uretero-intestinal anastomosis», «bladder cancer», and «neobladder». For citation in the article, 44 publications were selected. We also present our own data – long-term functional results of radical cystectomy for muscle-invasive bladder cancer for the period from 2016 to 2020. Results. The article presents a literature review on the development of modern methods for creating uretero-intestinal anastomoses in various clinical situations. The methods are presented in chronological order of their description in the literature, indicating the advantages, disadvantages and long-term results. In all 75 cases included in the analysis, a direct uretero-intestinal anastomosis was performed. In the early postoperative period, the failure of the anastomosis with the development of urinary peritonitis was detected in 2 (2.7%) patients. Six months after the operation, unilateral anastomotic stricture was detected in 2 patients (2.7%). Reflux of urine, without radiological signs of expansion of the renal cavity system and decreased renal function, was observed in 1 patient after orthoptic plastic surgery of the bladder. Conclusion. Performing urinary-intestinal anastomoses without antireflux mechanisms does not lead to deterioration of long-term functional results and is associated with a low frequency of strictures.

scholarly journals Long-term functional results of orthotopic urinary derivation by Studer and VIP after radical cystectomy in women

2020 ◽  
Vol 8 (2) ◽  
pp. 10-20
Author(s):  
V. A. Atduev ◽  
Yu. O. Lyubarskaya ◽  
D. S. Ledyaev ◽  
Z. K. Kushaev
Keyword(s):  
Urinary Incontinence ◽  
Plastic Surgery ◽  
Radical Cystectomy ◽  
Functional Results ◽  
Intraluminal Pressure ◽  
Long Term Results ◽  
Residual Urine ◽  
Physiological Capacity ◽  
Urinary Reservoir

Introduction. The feasibility of reconstructing an orthotopic urinary reservoir after radical cystectomy (RCE) in women is still debatable. This is due to the peculiarities of the physiology and anatomy of the female lower urinary tract and an increased risk of developing urinary incontinence or urinary retention after surgery.Purpose of the study. Studying long-term functional results of creating an orthotopic urinary reservoir by VIP in comparison with the technique of creating a urinary reservoir by Studer after RCE in women.Materials and methods. The study included 32 women who underwent RCE with the formation of an orthotopic urinary reservoir by to Studer — 13 patients and a «spherical» reservoir in the VIP — 19 modification. At the time of surgery, the age of patients was 61.1±1.9 years (29 ‒ 82). The average follow-up time was 77.5±7.8 months (17 ‒ 157, median 82). The patients who underwent a more complex type of plastic were younger than the patients operated on by the Studer method (p = 0.014). The groups did not differ statistically in other parameters.Results. The overall five-year survival rate in the Studer group was 90.9%, and in the VIP group — 94.7% (p = 0.596). 59.4% of patients were completely continent. Women after plastic surgery by VIP held urine better (68.4% vs 46.2%). The incidence of mild urinary incontinence was higher after Studer surgery. The incidence of severe urinary incontinence was the same in both groups. Nighttime urinary incontinence was the same in both groups. Intermittent catheterization was used more often by patients after VIP plastic surgery than after Studer surgery (21% vs 7.7%). In urodynamic studies, it was shown that the lower physiological capacity of the reservoir according to Studer due to more intense peristalsis of the reservoir wall, which causes involuntary leaking of urine, hyperperistalsis of the reservoir and a higher frequency of urinary incontinence causes more complete emptying in patients less residual urine, less need for self-catheterization. In the group of patients with plastic surgery according to VIP, a high physiological capacity of the reservoir with a lower pressure of the walls of the reservoir during the filling phase was recorded. This is manifested by a lower incidence of urinary incontinence, and, at the same time, a more significant amount of residual urine and a higher need for patients for self-catheterization.Conclusion. The formation of an orthotopic urinary reservoir with favourable long-term results is possible in women after RCE. The most beneficial in terms of the quality of daily held urine is the VIP modification, which is characterized by sufficiently high capacity and low intraluminal pressure. However, with this method of surgery, the risk of hypercontinence increases, which requires periodic catheterization. A complex urodynamic study made it possible to show the direct effect of various characteristics of the reservoir on the nature and degree of impaired urination of patients.

Long-term results of radical cystectomy in women with bladder cancer

2020 ◽  
Vol 9 (6) ◽  
pp. 12
Author(s):  
V.A. Atduev ◽  
Z.K. Kushaev ◽  
D.S. Ledyaev ◽  
V.E. Gasrataliev ◽  
I.S. Shevelev
Keyword(s):  
Bladder Cancer ◽  
Radical Cystectomy ◽  
Long Term Results

scholarly journals Long-Term Results of a Standard Algorithm for Intravenous Port Implantation

2021 ◽  
Vol 11 (5) ◽  
pp. 344
Author(s):  
Ching-Feng Wu ◽  
Jui-Ying Fu ◽  
Chi-Tsung Wen ◽  
Chien-Hung Chiu ◽  
Ming-Ju Hsieh ◽  
...  
Keyword(s):  
Operative Time ◽  
Functional Results ◽  
Long Term Results ◽  
Related Complication ◽  
Standard Algorithm ◽  
Port Implantation ◽  
Male Patients ◽  
Catheter Fracture ◽  
Guided Puncture

Intravenous ports serve as vascular access and are indispensable in cancer treatment. Most studies are not based on a systematic and standardized approach. Hence, the aim of this study was to demonstrate long-term results of port implantation following a standard algorithm. A total of 2950 patients who underwent intravenous port implantation between March 2012 and December 2018 were included. Data of patients managed following a standard algorithm were analyzed for safety and long-term outcomes. The cephalic vein was the predominant choice of entry vessel. In female patients, wire assistance without use of puncture sheath was less likely and echo-guided puncture via internal jugular vein (IJV) with use of puncture sheath was more likely to be performed, compared to male patients (p < 0.0001). The procedure-related complication rate was 0.07%, and no pneumothorax, hematoma, catheter kinking, catheter fracture, or pocket erosion was reported. Catheter implantations by echo-guided puncture via IJV notably declined from 4.67% to 0.99% (p = 0.027). Mean operative time gradually declined from 37.88 min in 2012 to 23.20 min in 2018. The proposed standard algorithm for port implantation reduced the need for IJV echo-guided approach and eliminated procedure-related catastrophic complications. In addition, it shortened operative time and demonstrated good functional results.

Contemporary Treatment for Central Serous Chorioretinopathy

2021 ◽  
Author(s):  
Mitova D
Keyword(s):  
Subretinal Fluid ◽  
Functional Results ◽  
Clinical Results ◽  
Long Term Results ◽  
Nanosecond Laser ◽  
Success Rates ◽  
Invasive Treatment ◽  
Non Invasive ◽  
Short And Long Term

Aim: To study the short-and long-term results of 2RT nanosecond laser treatment for CSC. To compare clinical results with those with AntiVEGF. Methods: Nanosecond laser (2RT, Ellex) was used. Patients were followed by BCVA, FAF, OCT, Angio-OCT. Results: 90% of the patient treated with 2RT had improvement of visual acuity and contrast sensitivity. 19 % [1] patients showed no improvement. 81% of the 2RT treated patients had total resorbtion of subretinal fluid against 60% treated with AntiVEGF. Functional results correlated with the atrophy of RPE in the macula. 46% (19 patients) had resolution on the first month, 23% [2]-on the third and 12% [3]-on the sixth month. The time of resolution shows no relation to the baseline pigment epithelial atrophy. Four patients presented with a recurrency of the disease in the follow-up period. 19% [1] were non responders. 60% of AntiVEGF treated eyes were responders and 40% were non responders. Those who responded to treatment needed between 3 and 10 injections. Conclusion: 2 RT is a non-invasive treatment modality with no adverse effects and high success rates.

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