Laparoscopic mid sagittal hemicystectomy and bladder reconstruction with small intestinal submucosa and reimplantation of ureter into small intestinal submucosa: 1-year followup

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dc.contributor.author Landman, J.
dc.contributor.author Olweny, E.
dc.contributor.author Sundaram, C. P.
dc.contributor.author Andreoni, C.
dc.contributor.author Collyer, W. C.
dc.contributor.author Rehman, J.
dc.contributor.author Jerde, T. J.
dc.contributor.author Lin, H. K.
dc.contributor.author Lee, D. I.
dc.contributor.author Nunlist, E. H.
dc.contributor.author Humphrey, P. A.
dc.contributor.author Nakada, S. Y.
dc.contributor.author Clayman, R. V.
dc.date.accessioned 2016-01-24T12:37:12Z
dc.date.available 2016-01-24T12:37:12Z
dc.date.issued 2004-06-01
dc.identifier http://dx.doi.org/10.1097/01.ju.0000127756.64619.27
dc.identifier.citation Journal of Urology. Philadelphia: Lippincott Williams & Wilkins, v. 171, n. 6, p. 2450-2455, 2004.
dc.identifier.issn 0022-5347
dc.identifier.uri http://repositorio.unifesp.br/handle/11600/27785
dc.description.abstract Purpose: We evaluated the long-term results of laparoscopic hemicystectomy and bladder replacement with small intestinal submucosa (SIS) with ureteral reimplantation into the SIS material.Materials and Methods: A total of 12 minipigs underwent laparoscopic hemicystectomy. Six pigs underwent bladder reconstruction with SIS and ipsilateral ureteral reimplantation. the remaining 6 control pigs underwent hemicystectomy and primary bladder closure with ipsilateral nephroureterectomy. Preoperative and followup evaluations included blood chemistry, radiography and urodynamic evaluations. the 6, 3, 6 and 9-week, and 12-month followup evaluations included biopsies. At 1 year the animals were sacrificed. Histopathological and contractility studies, and reverse transcriptase-polymerase chain reaction for growth factors and basement membrane components were performed.Results: Bladder capacity and bladder compliance were similar in the 2 groups at all time points. One pig per group died, that is a control at the 9-month evaluation due to an anesthetic complication and an SIS pig 7 months after bladder reconstruction due to spontaneous bladder rupture at the anastomotic site. in the SIS group 4 of 5 surviving pigs had unobstructed reimplanted ureters without evidence of hydroureteronephrosis, while 1 had high grade obstruction at the reimplantation site. Histopathology study after 1 year revealed muscle at the graft periphery and center but it consisted of small fused bundles with significant fibrosis. Nerves were present at the graft periphery and center but they were decreased in number.Conclusions: Laparoscopic SIS bladder reconstruction and ureteral reimplantation into the SIS after hemicystectomy are technically feasible. However, compared to primary bladder closure no advantage in bladder capacity or compliance was documented. en
dc.format.extent 2450-2455
dc.language.iso eng
dc.publisher Lippincott Williams & Wilkins
dc.relation.ispartof Journal of Urology
dc.rights Acesso restrito
dc.subject bladder en
dc.subject ureter en
dc.subject intestine en
dc.subject small en
dc.subject swine en
dc.subject urinary diversion en
dc.title Laparoscopic mid sagittal hemicystectomy and bladder reconstruction with small intestinal submucosa and reimplantation of ureter into small intestinal submucosa: 1-year followup en
dc.type Artigo
dc.contributor.institution Washington Univ
dc.contributor.institution Universidade Federal de São Paulo (UNIFESP)
dc.contributor.institution Univ Wisconsin
dc.contributor.institution Univ Oklahoma
dc.contributor.institution Univ Calif Irvine
dc.description.affiliation Washington Univ, Sch Med, Div Urol, St Louis, MO USA
dc.description.affiliation Washington Univ, Sch Med, Dept Pathol, St Louis, MO USA
dc.description.affiliation Universidade Federal de São Paulo, Dept Urol, São Paulo, Brazil
dc.description.affiliation Univ Wisconsin, Div Urol, Madison, WI USA
dc.description.affiliation Univ Oklahoma, Hlth Sci Ctr, Dept Urol, Oklahoma City, OK 73104 USA
dc.description.affiliation Univ Calif Irvine, Dept Urol, Irvine, CA USA
dc.description.affiliationUnifesp Universidade Federal de São Paulo, Dept Urol, São Paulo, Brazil
dc.identifier.doi 10.1097/01.ju.0000127756.64619.27
dc.description.source Web of Science
dc.identifier.wos WOS:000221510300107



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