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Multi-institutional experience with the gastrointestinal composite reservoir.
P F Austin1, J L Lockhart, N K Bissada
1Division of Urology, Washington University School of Medicine, St. Louis, Missouri, USA.
The Journal of Urology
|May 24, 2001
Summary
The gastrointestinal composite reservoir effectively manages metabolic acidosis and short bowel syndrome in complex patients. It offers excellent metabolic balance with few side effects, making it a preferred urinary diversion option.
Area of Science:
- Urology
- Gastroenterology
- Nephrology
Background:
- Patients with metabolic acidosis, short bowel syndrome, or pelvic radiation often require complex urinary diversion.
- Standard urinary reservoirs may be unsuitable for these compromised patient populations.
Purpose of the Study:
- To evaluate the multi-institutional experience with the gastrointestinal composite reservoir.
- To assess its metabolic impact and long-term sequelae in patients with specific complex conditions.
Main Methods:
- A retrospective review of 33 patients who underwent gastrointestinal composite reservoir construction across 4 institutions.
- Analysis included patients with short bowel syndrome, metabolic acidosis, and/or renal insufficiency.
- Data collected focused on metabolic parameters and complications.
Main Results:
- Significant improvement in serum chloride, bicarbonate, and pH was observed post-operatively (p < 0.05).
- Mean serum creatinine remained stable in patients with and without renal insufficiency.
- Complication rates were comparable to standard intestinal or gastric reservoirs.
Conclusions:
- The gastrointestinal composite reservoir provides excellent metabolic balance with minimal side effects in compromised patients.
- It is a suitable urinary diversion when standard options are not feasible due to metabolic acidosis, short bowel syndrome, or pelvic radiation.
- Its efficacy in cases of renal insufficiency requires further investigation.