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Continent Colonic Urinary Reservoir (Florida Pouch): Long-Term Surgical Complications (Greater Than 11 Years)

2003; Lippincott Williams & Wilkins; Volume: 169; Issue: 1 Linguagem: Inglês

10.1016/s0022-5347(05)64061-x

1527-3792

CHRISTOPHER WEBSTER, Satish Bukkapatnam, John D. Seigne, Julio M. Pow‐Sang, Mitchell Hoffman, Mohamed Helal, Raul Ordorica, Jorge L. Lockhart,

Amoebic Infections and Treatments

No AccessJournal of UrologyCLINICAL UROLOGY: Original Articles1 Jan 2003Continent Colonic Urinary Reservoir (Florida Pouch): Long-Term Surgical Complications (Greater Than 11 Years) CHRISTOPHER WEBSTER, RAVIENDER BUKKAPATNAM, JOHN D. SEIGNE, JULIO POW-SANG, MITCHELL HOFFMAN, MOHAMED HELAL, RAUL ORDORICA, and JORGE L. LOCKHART CHRISTOPHER WEBSTERCHRISTOPHER WEBSTER More articles by this author , RAVIENDER BUKKAPATNAMRAVIENDER BUKKAPATNAM More articles by this author , JOHN D. SEIGNEJOHN D. SEIGNE More articles by this author , JULIO POW-SANGJULIO POW-SANG More articles by this author , MITCHELL HOFFMANMITCHELL HOFFMAN More articles by this author , MOHAMED HELALMOHAMED HELAL More articles by this author , RAUL ORDORICARAUL ORDORICA Financial interest and/or other relationship with Johnson and Johnson (Alva), Pharmacia, Pfizer and Medtronic. More articles by this author , and JORGE L. LOCKHARTJORGE L. LOCKHART More articles by this author View All Author Informationhttps://doi.org/10.1016/S0022-5347(05)64061-XAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: We analyzed the long-term results (greater than 10 years) of a continent cutaneous colonic urinary reservoir (Florida pouch), focusing primarily on the incidence of significant complications. Materials and Methods: Between January 1986 and October 1991, 179 patients underwent continent cutaneous colonic urinary reservoir construction. Of these patients 105 died of primary disease or were lost to followup, leaving 38 males and 36 females with a mean followup of 133 months with adequate data for analysis who are the subject of this report. The surgical technique has been previously reported. Briefly, a detubularized right colonic segment forms the reservoir, a tapered external limb reinforced at the ileocecal valve level allows continent catheterization and the ureters are directly anastomosed to the pouch. The diseases that prompted urinary diversion included bladder cancer in 28 cases, conversion from another diversion in 12, neurogenic bladder in 11, interstitial cystitis in 10, crippling incontinence in 4, radiation cystitis in 6, hemorrhagic cystitis in 1, exstrophy in 1 and colon cancer in 1. A total of 146 direct ureterocolonic reimplantations were performed. Results: Complications were grouped by etiology and the number of patients, including abdominal wall (peristomal hernia in 3 patients or 4%), external limb (incontinence in 5 or 6.7%, stomal stenosis in 3 or 4% and difficult catheterization in 1 or 1.4%), reservoir stones (4 or 5.4%), ureteral obstruction (primary reimplantation in 7 of 108 or 6.3%, repeat reimplantation in 4 of 24 or 16.4% and radiated ureters in 4 of 14 or 28.4%) and metabolic (persistent diarrhea in 2 or 2.7%, renal failure in 2 or 2.7% and low vitamin B12 in 3 or 4%). Severe acidosis developed in 4 individuals (5.5%). Of the 12 patients who underwent conversion from another type of diversion 7 (58%) experienced metabolic alterations. Conclusions: In the long term continent colonic reservoirs have an acceptable complication rate. The most common problem is ureteral obstruction, especially in patients who have previously undergone irradiation (28.4% versus 6.3%, Fisher’s test p = 0.02). Patients in whom longer bowel segments were resected, such as those with conversion from another type of diversions, experienced a greater number of complications, especially ureteral obstruction associated with repeat reimplantation (16.4% versus 6.3%, Fisher’s test p = 0.23) and metabolic derangements (58% versus 6.4%, Fisher’s test p = 0.0001). References 1 : Le réservoir iléal de substitution après la cystectomie totale chez l'homme. J d'Urol1951; 57: 408. Google Scholar 2 : An alternative method for continent supravesical diversion. Soc Pediatr Urol Newsl1987; 3: 18. Google Scholar 3 : The cecoileal continent urinary reservoir. World J Urol1985; 3: 185. Crossref, Google Scholar 4 : The Mainz pouch (mixed augmentation) in continent urinary diversion. World J Urol1985; 3: 179. Crossref, Google Scholar 5 : Stapled and non-stapled tapered distal ileum for construction of a continent colonic urinary reservoir. J Urol1988; 140: 491. Link, Google Scholar 6 : A continent colonic urinary reservoir: the Florida pouch. J Urol1990; 144: 864. Link, Google Scholar 7 : Direct (nontunneled) ureterocolonic reimplantation in association with continent reservoirs. J Urol1993; 150: 835. Link, Google Scholar 8 : Right colon reservoir. In: Glenn's Urologic Surgery. Edited by . Philadelphia: Lippincott-Raven1998: 637. Google Scholar 9 : Evaluation and management of parastomal hernia in association with continent urinary diversion. J Urol1997; 157: 1630. Link, Google Scholar 10 Shukla, A.R., Pow-Sang, J.M., Helal, M.A., Seigne, J., Ordorica, R., Lockhart, J.L.: Urinary incontinence following continent urinary diversion using cecal wrap or plicated ileum: a patient questionnaire review. Unpublished data. Google Scholar 11 : Evaluation and management of mechanical dysfunction in continent colonic urinary reservoirs. J Urol2000; 163: 1679. Link, Google Scholar 12 : Stone risk factors in patients with continent urinary diversion. J Endourol1998; 12: s160. Google Scholar 13 : The pathophysiology of hyperchloremic metabolic acidosis after urinary diversion through intestinal segments. Surgery1985; 98: 561. Medline, Google Scholar 14 : Acid-base changes following urinary tract reconstruction for continent diversion and orthotopic bladder replacement. J Urol1994; 152: 338. Link, Google Scholar 15 : Complications of continent cutaneous reservoirs and neobladders—series using contemporary techniques. AUA Update Series1995; XIV. lesson 25. Google Scholar 16 : Construction of the Florida pouch with radiated bowel: results and complications. J Urol1992; 147: 391A. abstract 715. Google Scholar From the Division of Urology, Interdisciplinary Oncology Group, Departments of Surgery and Obstetrics and Gynecology, University of South Florida Health Sciences Center, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida© 2003 by American Urological Association, Inc.FiguresReferencesRelatedDetailsCited by Korkes F, Fernandes E, Gushiken F, Glina F, Baccaglini W, Timóteo F and Glina S (2022) Bricker ileal conduit vs. Cutaneous ureterostomy after radical cystectomy for bladder cancer: a systematic reviewInternational braz j urol, 10.1590/s1677-5538.ibju.2020.0892, VOL. 48, NO. 1, (18-30) Hampel C (2022) Kontinente Harnableitungen Die Urologie, 10.1007/978-3-642-41168-7_99-2, (1-38), . Van Ginkel C, Cobussen-Boekhorst H, Martens F, Feitz W and Heesakkers J (2021) The functioning and the complication rate of extreme long existing urinary diversionsCurrent Opinion in Urology, 10.1097/MOU.0000000000000928, VOL. 31, NO. 6, (562-569), Online publication date: 1-Nov-2021. Lampel A and Schultz-Lampel D (2021) Harnableitung nach uro-onkologischen Eingriffen bei Frauen: was bei wem?Aktuelle Urologie, 10.1055/a-1377-2328, VOL. 52, NO. 03, (268-275), Online publication date: 1-Jun-2021. Myers J, Martin C, Cheng P, Zhang C and Presson A (2019) Outcomes of right colon continent urinary pouch using standardized reporting methodsNeurourology and Urodynamics, 10.1002/nau.23951, VOL. 38, NO. 5, (1290-1297), Online publication date: 1-Jun-2019. (2018) Open Techniques and Extent (Including Pelvic Lymphadenectomy) Bladder Cancer, 10.1016/B978-0-12-809939-1.00024-2, (369-437), . Pooleri G and Sivasankaran N (2017) Selection of Bowel for Urinary Diversion and Choice of Diversion for Indian PatientsIndian Journal of Surgical Oncology, 10.1007/s13193-016-0589-y, VOL. 8, NO. 3, (337-342), Online publication date: 1-Sep-2017. Abd elwahab K, Eliwa A, Seleem M, Ali M, El-Babouly I, Ragab A, Naguib M, Desouky H, Desoky E, Omran M and Kamel H (2017) W-pouch With Modified Non-isolated Extra Limb for Continence in Cutaneous Diversion After Radical CystectomyUrology, 10.1016/j.urology.2017.04.006, VOL. 105, (202-207), Online publication date: 1-Jul-2017. Warner J and Chan K (2017) Continent Cutaneous Urinary Diversion Urinary Diversion, 10.1007/978-3-319-52186-2_4, (39-54), . Johnsen N and Miller N (2016) Surgical and Metabolic Management of Urolithiasis Following Bladder ReconstructionCurrent Bladder Dysfunction Reports, 10.1007/s11884-016-0396-x, VOL. 11, NO. 4, (310-316), Online publication date: 1-Dec-2016. Hampel C (2016) Kontinente Harnableitungen Die Urologie, 10.1007/978-3-642-39940-4_99, (811-848), . Khalil F, Fellahi S, Ouslim H, Mhanna T, El Houmaidi A, Aynaou M, Boteng P, Barki A and Nouini Y (2019) Long-term follow-up after ileocaecal continent cutaneous urinary diversion (Mainz I pouch): A retrospective study of a monocentric experienceArab Journal of Urology, 10.1016/j.aju.2015.09.004, VOL. 13, NO. 4, (245-249), Online publication date: 1-Dec-2015. Skinner E (2015) Continent cutaneous diversionCurrent Opinion in Urology, 10.1097/MOU.0000000000000225, VOL. 25, NO. 6, (555-561), Online publication date: 1-Nov-2015. Hauser N and Lee R (2015) Urinary diversion after radical cystectomy for bladder cancer: options, patient selection and outcomes Advances in Bladder Cancer Management, 10.2217/fmeb2013.13.18, (174-190), Online publication date: 1-Oct-2015. Hampel C (2015) Kontinente Harnableitungen Die Urologie, 10.1007/978-3-642-41168-7_99-1, (1-48), . Pearce S, Cohn J, Steinberg Z and Steinberg G (2014) Patient Selection, Operative Technique, and Contemporary Outcomes of Continent Catheterizable Diversion: the Indiana PouchCurrent Bladder Dysfunction Reports, 10.1007/s11884-014-0265-4, VOL. 9, NO. 4, (293-301), Online publication date: 1-Dec-2014. Lee R, Abol-Enein H, Artibani W, Bochner B, Dalbagni G, Daneshmand S, Fradet Y, Hautmann R, Lee C, Lerner S, Pycha A, Sievert K, Stenzl A, Thalmann G and Shariat S (2013) Urinary diversion after radical cystectomy for bladder cancer: options, patient selection, and outcomesBJU International, 10.1111/bju.12121, VOL. 113, NO. 1, (11-23), Online publication date: 1-Jan-2014. Stein R, Schröder A and Thüroff J (2012) Bladder augmentation and urinary diversion in patients with neurogenic bladder: Surgical considerationsJournal of Pediatric Urology, 10.1016/j.jpurol.2011.11.014, VOL. 8, NO. 2, (153-161), Online publication date: 1-Apr-2012. Stein R, Schröder A and Thüroff J (2012) Bladder augmentation and urinary diversion in patients with neurogenic bladder: Non-surgical considerationsJournal of Pediatric Urology, 10.1016/j.jpurol.2011.03.015, VOL. 8, NO. 2, (145-152), Online publication date: 1-Apr-2012. Hampel C, Thomas C, Thüroff J and Roos F (2012) Ureterimplantationsstenose und symptomatischer RefluxSymptomatic reflux and stenosis of ureteroenteric anastomosisDer Urologe, 10.1007/s00120-012-2812-y, VOL. 51, NO. 4, (477-484), Online publication date: 1-Apr-2012. Okhunov Z, Duty B, Smith A and Okeke Z (2011) Management of urolithiasis in patients after urinary diversionsBJU International, 10.1111/j.1464-410X.2011.10194.x, VOL. 108, NO. 3, (330-336), Online publication date: 1-Aug-2011. Stein R, Schröder A and Thüroff J (2011) Harnableitung bei KindernUrinary diversion in childhoodDer Urologe, 10.1007/s00120-011-2526-6, VOL. 50, NO. 5, (557-565), Online publication date: 1-May-2011. Rink M, Kluth L, Eichelberg E, Fisch M and Dahlem R (2010) Continent Catheterizable Pouches for Urinary DiversionEuropean Urology Supplements, 10.1016/j.eursup.2010.09.003, VOL. 9, NO. 10, (754-762), Online publication date: 1-Dec-2010. López Gil R, Zamora F, Anzola J, Lemos C and Rodríguez N (2010) Bolsa de Indiana en el tratamiento de tumores malignos de la pelvis y de sus secuelas. Experiencia de 20 años en el Instituto Nacional de CancerologíaRevista Colombiana de Cancerología, 10.1016/S0123-9015(10)70113-X, VOL. 14, NO. 1, (37-46), . Honeck P, Michel M, Trojan L and Alken P (2008) An alternative continence tube for continent urinary reservoirs: evaluation of surgical technique, pressure and continence study in an ex-vivo modelWorld Journal of Urology, 10.1007/s00345-008-0297-5, VOL. 27, NO. 1, (131-137), Online publication date: 1-Feb-2009. Porter C and Hanson G (2009) Complications of Urinary Diversion Reoperative Pelvic Surgery, 10.1007/b14187_17, (213-221), . Fisch M and Thüroff J (2008) Continent cutaneous diversionBJU International, 10.1111/j.1464-410X.2008.07976.x, VOL. 102, NO. 9b, (1314-1319), Online publication date: 1-Nov-2008. Kälble T and Roth S (2008) Serosa Lined and Tapered Ileum as Primary and Secondary Continence Mechanism for Various Catheterizable PouchesJournal of Urology, VOL. 180, NO. 5, (2053-2057), Online publication date: 1-Nov-2008. Cavaller A, Carlos da Silva D, de Granville Ponce F, dos Santos M, Netto N and D'Ancora C (2008) Transverse Colon for Continent Urinary Diversion: Experimental Study Comparing Two TechniquesUrology, 10.1016/j.urology.2008.06.005, VOL. 72, NO. 4, (908-912), Online publication date: 1-Oct-2008. Wiesner C and Thüroff J (2008) USE OF BOWEL IN LOWER URINARY TRACT RECONSTRUCTION IN WOMEN Female Urology, 10.1016/B978-1-4160-2339-5.50145-2, (973-993), . Fisch M (2007) Entwicklung kontinenter ReservoireDevelopment of continent reservoirsDer Urologe, 10.1007/s00120-007-1608-y, VOL. 47, NO. 1, (25-32), Online publication date: 1-Jan-2008. Stolzenburg J, Schwalenberg T, Liatsikos E, Sakelaropoulos G, Rödder K, Hohenfellner R and Fisch M (2007) Colon pouch (Mainz III) for continent urinary diversionBJU International, 10.1111/j.1464-410X.2007.06767.x, VOL. 99, NO. 6, (1473-1477), Online publication date: 1-Jun-2007. Ruffion A, Traxer O and Chartier-Kastler E (2007) Chapitre A - Lithiase et vessie neurogèneProgrès en Urologie, 10.1016/S1166-7087(07)92340-4, VOL. 17, NO. 3, (417-423), Online publication date: 1-May-2007. Parekh D and Donat S (2007) Urinary Diversion: Options, Patient Selection, and OutcomesSeminars in Oncology, 10.1053/j.seminoncol.2006.12.010, VOL. 34, NO. 2, (98-109), Online publication date: 1-Apr-2007. Bakke A, Jensen K, Jonsson O, Jónsson E, Månsson W, Paananen I, Schultz A, Thind P and Tuhkanen K (2009) The rationale behind recommendations for follow-up after urinary diversion: An evidence-based approachScandinavian Journal of Urology and Nephrology, 10.1080/00365590600991284, VOL. 41, NO. 4, (261-269), Online publication date: 1-Jan-2007. Schumacher M, Burkhard F and Studer U Emergencies in Continent Bladder Replacement Emergencies in Urology, 10.1007/978-3-540-48605-3_31, (444-450) Aleman M, Abdelmalak J and Rackley R (2007) Augmentation Cystoplasty Female Urology, 10.1007/978-1-59745-368-4_17, (251-259), . Parekh D, Bochner B and Dalbagni G (2006) Superficial and Muscle-Invasive Bladder Cancer: Principles of Management for Outcomes AssessmentsJournal of Clinical Oncology, 10.1200/JCO.2006.08.5431, VOL. 24, NO. 35, (5519-5527), Online publication date: 10-Dec-2006. Wiesner C, Bonfig R, Stein R, Gerharz E, Pahernik S, Riedmiller H and Thüroff J (2006) Continent cutaneous urinary diversion: long-term follow-up of more than 800 patients with ileocecal reservoirsWorld Journal of Urology, 10.1007/s00345-006-0078-y, VOL. 24, NO. 3, (315-318), Online publication date: 1-Aug-2006. Wiesner C, Stein R, Pahernik S, Hähn K, Melchior S and Thüroff J (2018) Long-Term Followup of the Intussuscepted Ileal Nipple and the In Situ, Submucosally Embedded Appendix as Continence Mechanisms of Continent Urinary Diversion With the Cutaneous Ileocecal Pouch (Mainz Pouch I)Journal of Urology, VOL. 176, NO. 1, (155-160), Online publication date: 1-Jul-2006. Burkhard F, Kessler T, Mills R and Studer U (2006) Continent urinary diversionCritical Reviews in Oncology/Hematology, 10.1016/j.critrevonc.2005.06.008, VOL. 57, NO. 3, (255-264), Online publication date: 1-Mar-2006. Curry N Small Renal Neoplasms Imaging of Kidney Cancer, 10.1007/3-540-30003-1_13, (203-218) von Unruh G, Ernst F, Schmidt M, Steiner G, Hesse A and Müller S (2005) Intestinal oxalate absorption in patients with continent urinary diversionWorld Journal of Urology, 10.1007/s00345-005-0031-5, VOL. 23, NO. 5, (334-337), Online publication date: 1-Nov-2005. NABI G, YONG S, ONG E, McPHERSON G, GRANT A and N’DOW J (2018) IS ORTHOTOPIC BLADDER REPLACEMENT THE NEW GOLD STANDARD? EVIDENCE FROM A SYSTEMATIC REVIEWJournal of Urology, VOL. 174, NO. 1, (21-28), Online publication date: 1-Jul-2005. Karsenty G, Moutardier V, Lelong B, Guiramand J, Houvenaeghel G, Delpero J and Bladou F (2005) Long-term follow-up of continent urinary diversion after pelvic exenteration for gynecologic malignanciesGynecologic Oncology, 10.1016/j.ygyno.2004.12.009, VOL. 97, NO. 2, (524-528), Online publication date: 1-May-2005. Antolak C, Canales B and Monga M (2005) Medial thigh pain: Neurology or urology?Urology, 10.1016/j.urology.2004.10.056, VOL. 65, NO. 4, (799), Online publication date: 1-Apr-2005. Wiesner C and Thüroff J (2004) Techniques for uretero-intestinal reimplantationCurrent Opinion in Urology, 10.1097/00042307-200411000-00010, VOL. 14, NO. 6, (351-355), Online publication date: 1-Nov-2004. Farnham S and Cookson M (2004) Surgical complications of urinary diversionWorld Journal of Urology, 10.1007/s00345-004-0429-5, VOL. 22, NO. 3, (157-167), Online publication date: 1-Sep-2004. Brandt F, Lorenzato F and Albuquerque C (2004) Transplante de bexiga: estudo pilotoActa Cirurgica Brasileira, 10.1590/S0102-86502004000400015, VOL. 19, NO. 4, (448-455), Online publication date: 1-Aug-2004. ABOL-ENEIN H, SALEM M, MESBAH A, ABDEL-LATIF M, KAMAL M, SHABAAN A and GHONEIM M (2018) CONTINENT CUTANEOUS ILEAL POUCH USING THE SEROUS LINED EXTRAMURAL VALVES. THE MANSOURA EXPERIENCE IN MORE THAN 100 PATIENTSJournal of Urology, VOL. 172, NO. 2, (588-591), Online publication date: 1-Aug-2004. Carrion R, Arap S, Corcione G, Ferreyra U, Neyraargote G, Cantor A, Seigne J and Lockhart J (2004) A multi-institutional studyof orthotopic neobladders: functional results in men and womenBJU International, 10.1111/j.1464-410X.2003.04743.x, VOL. 93, NO. 6, (803-806), Online publication date: 1-Apr-2004. Salom E, Mendez L, Schey D, Lambrou N, Kassira N, Gómez-Marı́n O, Averette H and Peñalver M (2004) Continent ileocolonic urinary reservoir (Miami pouch): the University of Miami experience over 15 yearsAmerican Journal of Obstetrics and Gynecology, 10.1016/j.ajog.2004.01.023, VOL. 190, NO. 4, (994-1000), Online publication date: 1-Apr-2004. Volpe A, Panzarella T, Rendon R, Haider M, Kondylis F and Jewett M (2004) The natural history of incidentally detected small renal massesCancer, 10.1002/cncr.20025, VOL. 100, NO. 4, (738-745), Online publication date: 15-Feb-2004. Volume 169Issue 1January 2003Page: 174-176 Advertisement Copyright & Permissions© 2003 by American Urological Association, Inc.Keywordspostoperative complicationsurinary diversionmetabolismcolonMetrics Author Information CHRISTOPHER WEBSTER More articles by this author RAVIENDER BUKKAPATNAM More articles by this author JOHN D. SEIGNE More articles by this author JULIO POW-SANG More articles by this author MITCHELL HOFFMAN More articles by this author MOHAMED HELAL More articles by this author RAUL ORDORICA Financial interest and/or other relationship with Johnson and Johnson (Alva), Pharmacia, Pfizer and Medtronic. More articles by this author JORGE L. LOCKHART More articles by this author Expand All Advertisement PDF downloadLoading ...