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العنوان
Role of multidetector ct in the assessment of urinary diversion /
المؤلف
Khedr, Mohamed Zakaria Ali.
هيئة الاعداد
باحث / محمد زكريا علي خضر
مشرف / مدحت محمد رفعت
مشرف / إسلام محمود الشاذلي
مشرف / مدحت محمد رفعت
الموضوع
Urinary diversion. computer tomography.
تاريخ النشر
2017.
عدد الصفحات
76 p. :
اللغة
الإنجليزية
الدرجة
ماجستير
التخصص
الأشعة والطب النووي والتصوير
تاريخ الإجازة
1/1/2017
مكان الإجازة
جامعة بنها - كلية طب بشري - الاشعه
الفهرس
Only 14 pages are availabe for public view

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Abstract

Urinary diversion is any one of several surgical procedures to reroute urine flow from its normal pathway. It may be necessary for diseased or defective ureters, bladder or urethra, either temporarily or permanently (Hautmann, 2003).
The frequency distribution of urinary diversions performed by the World Health Organization (WHO) and the Société Internationale d’Urologie (SIU) in >7000 patients with cystectomy reflects the current status of urinary diversion after cystectomy for bladder cancer: neobladder, 47%; conduit, 33%; anal diversion, 10%; continent cutaneous diversion, 8%; &incontinent cutaneous diversion, 2% ( Hautmann et al, 2007).
Numerous surgical procedures have been developed for urinary diversion in patients who have undergone a radical cystectomy for bladder cancer. Because urinary diversion procedures are complex, early and late postsurgical complications frequently occur. Possible complications include alterations in bowel motility, anastomotic leaks, backpressure changes, fluid collections (abscess, urinoma, lymphocele, and hematoma), fistulas, peristomal herniation, ureteral strictures, calculi, and tumor recurrence (Catala et al, 2009).
The goals of urinary diversion after cystectomy have evolved from simple diversion and protection of the upper tracts to functional and anatomic restoration as close as possible to the natural preoperative state. This evolution of urinary diversion has developed along 3 distinct paths: incontinent cutaneous diversion (conduit) , continent cutaneous diversion (pouch) and most recently continent urinary diversion to the intact native
urethra (neobladder, orthotopic reconstruction) ( Steinberg and Curti, 2010).
Computed tomography (CT) is an accurate method for evaluating such events. Multiplanar reformatting and three-dimensional volume rendering of multidetector CT image data are particularly useful for achieving an accurate and prompt diagnosis of complications and obtaining information that is essential for adequate surgical management.The diversity of the surgical procedures and of the resultant postoperative anatomic changes makes image interpretation difficult. Familiarity with the normal postoperative anatomy and with optimal CT technique is essential to achieve correct diagnosis (Kouba, 2007).
Multidetector CT Urography is a relatively new imaging technique that allows more rapid evaluation of the urinary system. The image data can be transferred to a workstation, allowing multiplanar reformatting and three dimensional (3D) reconstruction. Advantages of multidetector CT Urography over intravenous Urography and fluoroscopic loopography include the ability to detect and characterize extraurinary findings (eg, common fluid collections, intestinal complications, tumor recurrence) and to better identify uroepithelial lesions. In addition, multidetector CT is not limited by the body habitus or the presence of abundant stool or intestinal gas, which may hinder evaluation with intravenous Urography (Mattie et al, 2008).