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[Orthotopic replacement with hemi-Kock or W]

¹Centro di Urologia e Nefrologia, Università di Mansoura, Egitto.

Chirurgia Italiana

|January 1, 1997

Summary

This study presents a novel orthotopic bladder substitute technique for bladder cancer patients, achieving high continence rates with minimal complications. The W-shaped ileal neobladder offers a promising alternative for urinary diversion after cystectomy.

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Area of Science:

Urology
Surgical Oncology
Reconstructive Surgery

Context:

Bladder cancer treatment often requires cystectomy and urinary diversion.
Existing orthotopic neobladder techniques, like the hemi-Kock pouch, have associated complications.
Patient demographics and outcomes vary geographically.

Purpose:

To describe a modified orthotopic bladder substitute technique using ileum without staples or a nipple.
To evaluate the efficacy and safety of this revised procedure in patients with bladder carcinoma.
To report on postoperative continence rates and complications.

Summary:

A W-shaped ileal segment (40 cm) was used to create a neobladder, avoiding staples and nipple formation.
The technique involves specific ileal configuration and ureteral implantation into troughs with mucosal suturing.
The procedure was performed on 280 male and 38 female patients, with 87 males undergoing the revised technique.

Impact:

The revised technique demonstrates high daytime (94%) and night-time (78%) continence rates.
It offers a low morbidity and mortality option for urinary diversion.
This method provides a viable alternative for bladder cancer patients requiring radical cystectomy.

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