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Role of bowel suspension technique to prevent early intestinal obstruction after radical cystectomy with ileal orthotopic neobladder: A retrospective cohort study
- Title
- Role of bowel suspension technique to prevent early intestinal obstruction after radical cystectomy with ileal orthotopic neobladder: A retrospective cohort study
- Authors
- Song, Wan; Yoon, Hyun Suk; Kim, Kwang Hyun; Yoon, Hana; Chung, Woo Sik; Sim, Bong Suk; Lee, Dong Hyeon
- Ewha Authors
- 심봉석; 정우식; 이동현; 윤하나; 김광현
- SCOPUS Author ID
- 심봉석; 정우식; 이동현; 윤하나; 김광현
- Issue Date
- 2018
- Journal Title
- INTERNATIONAL JOURNAL OF SURGERY
- ISSN
- 1743-9191
1743-9159
- Citation
- INTERNATIONAL JOURNAL OF SURGERY vol. 55, pp. 9 - 14
- Keywords
- Bladder cancer; Bowel suspension; Ileal neobladder; Intestinal obstruction; Radical cystectomy
- Publisher
- ELSEVIER SCIENCE BV
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Objective: We investigate the impact of the bowel suspension technique (BST) on paralytic ileus and early intestinal obstruction (<= 60days) after radical cystectomy (RC) with ileal orthotopic neobladder (IONB). Methods: We retrospectively reviewed 310 patients who underwent RC with IONB for bladder cancer between 2001 and 2017. After forming the Studer IONB, ileal continuity was restored by side-to-side stapled anastomosis. Then, we suspended stapled anastomotic portion of bowel on the posterior peritoneum not to fall into the pelvic cavity. The clinicopathologic characteristics of patients were examined and the onset of paralytic ileus and early intestinal obstruction were identified. Logistic regression analysis was used to identify predictors associated with paralytic ileus and early intestinal obstruction. Results: Of the 310 total patients, paralytic ileus and early intestinal obstruction were identified in 100 (32.3%) and 15 (4.8%), respectively. When patients were divided into two groups (BST [-] vs. BST [+]), the rates of paralytic ileus were not significantly different (64/205[31.2%] vs. 36/105[34.3%], P=0.585). However, early intestinal obstruction that required surgical treatment was significantly decreased (14/205[6.8%] vs. 1/105[1.0%], P=0.024). On multivariate analysis, older age was commonly associated with paralytic ileus and early intestinal obstruction (P=0.008 and P=0.016). BST was inversely associated with early intestinal obstruction (95% CI: 0.01-0.85, P=0.034), but not related to paralytic ileus. Conclusion: BST significantly reduced early intestinal obstruction without increasing paralytic ileus after RC with IONB. BST could be used as useful technique to reduce severe bowel complications.
- DOI
- 10.1016/j.ijsu.2018.04.044
- Appears in Collections:
- 의과대학 > 의학과 > Journal papers
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