Techniques of Urological Reconstruction

  • Giuseppe Quarto
  • Raffaele Muscariello
  • Domenico Sorrentino
  • Sisto PerdonàEmail author
Part of the Updates in Surgery book series (UPDATESSURG)


Locally recurrent cancer or, less commonly, a bulky, primary tumor arising adjacent to the urologic organs, requires an extended operation for salvage. During surgery for colorectal carcinoma (CRC), or pelvic surgery, a carcinomatous infiltration of adjacent urological organs is found in 5–10% of all cases [1]. However, this rate increases to ~50% in T4 and even higher rates for rectal carcinomas, as it is only partially covered by the visceral peritoneum, and to ~80% in recurrent carcinomas [2]. In these advanced cases in particular, an inherent surgical problem is the impossibility of distinguishing between inflammation and malignant infiltration of the adjacent organs during surgery [3]. Total pelvic exenteration (PE) and its modifications are surgical options for treating locally advanced rectal cancer. Total PE may involve en bloc removal of the rectum, bladder, prostate, or ureters, since it is essential to create clear margins if the procedure is to be curative. As a result, patients often require double stomas, which severely compromise quality of life (QoL) despite achieving acceptable locoregional control.


Radical Cystectomy Urinary Diversion Pelvic Exenteration Ileal Conduit Bowel Continuity 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


  1. 1.
    Stief CG, Jonas U, Raab R (2002) Long-term follow-up after surgery for advanced colorectal carcinoma involving the urogenital tract. Eur Urol 41:546–550CrossRefPubMedGoogle Scholar
  2. 2.
    Harada K, Sakai I, Muramaki M et al (2006) Reconstruction of urinary tract combined with surgical management of locally advanced non-urological cancer involving the genitourinary organs. Urol Int 76:82–86CrossRefPubMedGoogle Scholar
  3. 3.
    Levin KE, Dozois RR (1991) Epidemiology of large bowel cancer. World J Surg 15:562–567CrossRefPubMedGoogle Scholar
  4. 4.
    Fujisawa M, Nakamura T, Ohno M et al (2002) Surgical management of the urinary tract in patients with locally advanced colorectal cancer. Urology 60:983–987CrossRefPubMedGoogle Scholar
  5. 5.
    Wein AJ, Kavoussi LR, Novick AC (eds) (2012) Campbell-Walsh Urology, 10th ed. Elsevier Saunders, PhiladelphiaGoogle Scholar
  6. 6.
    Rackley RR, Abdelmalak JB (2001) Laparoscopic augmentation cystoplasty. Surgical technique. Urol Clin North Am 28:663–670CrossRefPubMedGoogle Scholar
  7. 7.
    Pantuck AJ, Han KR, Perrotti M et al (2000) Ureteroenteric anastomosis in continent urinary diversion: long-term results and complications of direct versus nonrefluxing techniques. J Urol 163:450–455CrossRefPubMedGoogle Scholar
  8. 8.
    Hautmann S, Chun KH, Currlin E et al (2006) Refluxing chimney versus nonrefluxing LeDuc ureteroileal anastomosis for orthotopic ileal neobladder: a comparative analysis for patients with bladder cancer. J Urol 175:1389–1393 (discussion 1393-–1394)CrossRefPubMedGoogle Scholar
  9. 9.
    Bricker EM (1950) Bladder substitution after pelvic evisceration. Surg Clin North Am 3: 1511–1521Google Scholar
  10. 10.
    Kouba E, Sands M, Lentz A et al (2007) A comparison of the Bricker versus Wallace ureteroileal anastomosis in patients undergoing urinary diversion for bladder cancer. 78(3 Pt 1):945–948 (discussion 948–949)Google Scholar

Copyright information

© Springer-Verlag Italia 2016

Authors and Affiliations

  • Giuseppe Quarto
  • Raffaele Muscariello
  • Domenico Sorrentino
  • Sisto Perdonà
    • 1
    Email author
  1. 1.Urologic Surgical Oncology, Department of UrogynecologyIstituto Nazionale Tumori - IRCCS Fondazione G. PascaleNaplesItaly

Personalised recommendations