J 2013

Effect of ureterointestinal anastomosis on renal function and morbidity in intestinal urinary diversion

DOLEŽEL, Jan, Ivo CAPAK, Dalibor VALÍK, David MIKLANEK, Daniel MACÍK et. al.

Basic information

Original name

Effect of ureterointestinal anastomosis on renal function and morbidity in intestinal urinary diversion

Authors

DOLEŽEL, Jan (203 Czech Republic, belonging to the institution), Ivo CAPAK (203 Czech Republic), Dalibor VALÍK (203 Czech Republic, belonging to the institution), David MIKLANEK (203 Czech Republic), Daniel MACÍK (203 Czech Republic), Milos PACAL (203 Czech Republic), Michal STANÍK (703 Slovakia) and Jiří JARKOVSKÝ (203 Czech Republic, guarantor, belonging to the institution)

Edition

SCANDINAVIAN JOURNAL OF UROLOGY, LONDON, INFORMA HEALTHCARE, 2013, 2168-1805

Other information

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

United Kingdom of Great Britain and Northern Ireland

Confidentiality degree

není předmětem státního či obchodního tajemství

RIV identification code

RIV/00216224:14110/13:00069740

Organization unit

Faculty of Medicine

DOI

UT WoS

000321415400010

Keywords in English

ureterointestinal anastomosis; urinary diversion; vesicoureteral reflux

Tags

International impact, Reviewed
Změněno: 15/10/2013 15:46, Soňa Böhmová

Abstract

V originále

Objective.The authors previously successfully applied the "flap-and-trough" (FT) method of antireflux ureterointestinal anastomosis (UIA) in a pilot set of 81 patients. This randomized prospective trial tested the effectiveness of this method in protecting the upper urinary tract from obstruction, reflux and infections. Material and methods. Forty-nine patients indicated for cystectomy and intestinal urinary diversion were randomly split into two groups, A and B. The FT antireflux UIA was applied in group A (n = 20), and refluxing direct elliptical UIA in group B (n = 29). Both groups were divided into two subcategories according to the type of diversion used: Ar (n = 10) and Br (n = 16) with low-pressure reservoirs and Ac (n = 10) and Bc (n = 13) with conduits. The follow-up evaluation compared the groups regarding perioperative complications, antireflux efficiency of FT, occurrence of obstruction and urinary infection, kidney morphology and glomerular filtration rate. Results.During the follow-up period (median 31 months), the obstruction occurred only in group Br (insignificant difference compared to Ar). A significant decrease in glomerular filtration rate and shortening of the left kidney occurred in group Br during the period and in comparison with Ar. There were no other considerable divergences in other studied parameters. Conclusions.The antireflux FT anastomosis represents a low risk for stenosis. The reduced occurrence of obstructive complications in comparison with direct UIA was statistically insignificant. Its construction did not increase the frequency of complications; on the contrary, it guarantees a better protection of renal morphology and function.