Figure 1 - available from: Abdominal Radiology
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Segmental colectomy. Right colectomy: shaded gray portion of the terminal ileum and right colon is removed with ileal-transverse colon anastomosis (I-TC). Inset left colectomy with left transverse and descending colon resection and transverse–sigmoid colon anastomosis
Source publication
This article discusses the commonly encountered operative procedures of the colon and urinary diversions and provides a comprehensive review of indications, contraindications, surgical techniques with emphasis on normal and abnormal multimodality imaging findings.
Citations
... Orthotopic neobladder consists of a segment of detubularized bowel that is used as an internal urinary reservoir with a direct anastomosis to the native urethra. Although the reservoir may be constructed from large or small bowel, ileal neobladders are usually preferred [47,48]. Studer is the most common pouch created from terminal ileum, in which a longer segment of distal ileum is harvested to form the pouch, and the most proximal 10 cm of bowel is used as an afferent chimney. ...
Over the past several years, there has been a trend of decreasing screening or diagnostic fluoroscopic examinations ordered by clinical teams, particularly double contrast gastrointestinal studies. The underlying reason is due to increasing number of endoscopic procedures performed by Gastroenterology and Urology and usage of other imaging modalities, which are either more sensitive and/or offer the ability to obtain tissue for confirmation. Many fluoroscopic studies are now tailored toward patients who have undergone gastrointestinal or genitourinary oncologic surgeries, providing both functional and anatomic information, which are important tools for patient management. Some of these surgeries are very complex and an understanding of the postoperative anatomy and potential pitfalls is important to accurately evaluate for complications. The purpose of this article is to describe techniques and indications for common post-operative fluoroscopic procedures in gastrointestinal and genitourinary oncology while reviewing normal appearances. Complications, with emphasis on postoperative leaks, will be highlighted. Familiarity with the various types of gastrointestinal surgeries and urinary diversion techniques and knowledge of the expected postsurgical appearance is essential for achieving an accurate and prompt diagnosis of complications to allow for adequate treatment and management.
Graphical abstract
Objective
To review the different types of urinary diversion surgeries (UDS) in order to recognize the expected findings in a postoperative study, using different imaging techniques. To recognize the main postoperative complications, both early and late.
Conclusion
UDS are surgical procedures whose purpose is to redirect urine flow after cystectomy, generally in an oncologic context. The imaging evaluation of urological surgeries is often a radiological challenge, with CT being the most commonly used image modality. Therefore, it is essential to know the main surgical techniques, the expected postoperative findings and the optimization of imaging techniques for early diagnosis and correct evaluation of postoperative complications.
