Re: Orthotopic detaenial sigmoid neobladder after radical cystectomy: Technical considerations, complications and functional outcomes: K. Xu, C-X Liu, S-B. Zheng, H-L. Li, Y-W. Xu, A-B. Xu, B-S. Chen and H-Y. Shen J Urol 2013; 190: 928-934.

摘要

We appreciate the new surgical technique of making an orthotopic neobladder for patients undergoing radical cystectomy. It is well-known that blood vessels to the large intestine pass through the mesentery and, after penetrating the intestinal wall, they divide into small branches and capillaries, forming the vascular plexus in the submucosal layer of the large intestine. If we remove the serosa and muscularis externa using the detaenial technique, some of the vessels penetrating the muscularis externa to form the submucosal vascular plexus may be injured, which might lead to loss of vascularity of the mucosa and submucosa resulting in necrosis. Is this scenario only theoretical or did the authors experience any such complications in the early part of development of their technique?