Gastrointestinal function and metabolic control after construction of an orthotopic ileal neobladder in bladder cancer.
Research output: Contribution to journal › Journal article › Research › peer-review
OBJECTIVE: To investigate the effects of ileum resection in orthotopic neobladder construction on gastrointestinal function and metabolic control. MATERIAL AND METHODS: We included 28 patients who underwent radical cystectomy and construction of an orthotopic neobladder or continent ileal reservoir for bladder cancer. As controls, 10 patients endoscopically treated for non-invasive bladder cancer (TaG2) were enrolled. Gastrointestinal symptoms, enterohepatic bile salt circulation, gastric emptying and gastrointestinal hormones involved in metabolic control were monitored. RESULTS: Of the cystectomy patients, 25% experienced daily diarrhoea and faecal urgency due to bile acid malabsorption, compared to 0% of the controls (p = 0.013). The cystectomy patients experienced faster gastric emptying and had higher levels of peptide YY. Plasma concentrations of insulin, glucagon-like peptide-1 and glucose were unchanged. CONCLUSIONS: Using the distal ileum for orthotopic neobladder construction causes bowel disorders in a quarter of cystectomy patients. Diarrhoea and faecal urgency are probably caused by decreased reabsorption of bile and are not due to changes in gastrointestinal hormones. A sizeable proportion of patients develop bile salt-induced diarrhoea, which can be relieved by treatment with cholestyramine.
Original language | English |
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Journal | Scandinavian Journal of Urology and Nephrology |
Volume | 41 |
Issue number | 1 |
Pages (from-to) | 14-9 |
Number of pages | 5 |
ISSN | 0036-5599 |
DOIs | |
Publication status | Published - 2007 |
Bibliographical note
Keywords: Adult; Aged; Artificial Organs; Bile Acids and Salts; Cystectomy; Female; Gastric Emptying; Glucagon-Like Peptide 1; Humans; Ileum; Male; Middle Aged; Peptide YY; Recovery of Function; Urinary Bladder Neoplasms; Urinary Diversion
ID: 8417959