{
    "abstract": "To present our simplified technical modification of double-T continent cutaneous diversion (CCD) using Yang-Monti tubes.\nDuring 2008-2011, 8 adult patients underwent CCD; 4 had classical exstrophy, 2 bladder cancer, 1 recurrent vaginal cancer post-radiotherapy, and 1 prostate cancer with post-simple retropubic prostatectomy urethral stricture with incontinence. For reconstruction, a 45- to 50-cm segment of terminal ileum sparing 25 cm of terminal ileum was harvested. Its distal 3- to 6-cm and proximal 3-cm segments were separated on vascular pedicle and fashioned into Yang-Monti tubes (1 proximally and 1 or 2 distally). The middle 40- to 45-cm detubularized segment was fashioned into a \"W\" shape, and serosal aspects of adjacent loops were sutured together close to the mesentery. The tubes were implanted into the W pouch via extramural serosa-lined tunnel (Abol-Enein and Ghoneim). The pouch was closed transversely over an 18-Fr pouchostomy and 16-Fr stomal catheter. The ureters were implanted into the proximal tube using the Wallace principle, over 6- to 8-Fr infant feeding tubes exteriorized through the pouch. The distal end of the distal tube was made into a flush stoma.\nIn the early postoperative period, intestinal obstruction (2 cases), ureteroileal anastomotic leakage (3 cases) and vesico-ileocutaneous fistula (1 case) were encountered. No ureteroileal anastomotic obstruction or catherization-related difficulty was observed until the last follow-up (2 months to 3 years). Of 15 anastomoses, 14 were nonrefluxing.\nIleal double-T CCD using the Yang-Monti principle is technically feasible and relatively simple, particularly in nonirradiated ileum. However, early complications indicate a learning curve, and long-term follow-up and larger data are needed.",
    "authors": [
        {
            "affiliation": "Department of Urology, Postgraduate Institute of Medical Education and Research, Chandigarh, India. drmayank.22@gmail.com",
            "firstname": "Mayank Mohan",
            "initials": "MM",
            "lastname": "Agarwal"
        },
        {
            "affiliation": null,
            "firstname": "Ravimohan",
            "initials": "R",
            "lastname": "Mavuduru"
        },
        {
            "affiliation": null,
            "firstname": "Shrawan K",
            "initials": "SK",
            "lastname": "Singh"
        },
        {
            "affiliation": null,
            "firstname": "Arup K",
            "initials": "AK",
            "lastname": "Mandal"
        }
    ],
    "conclusions": "Ileal double-T CCD using the Yang-Monti principle is technically feasible and relatively simple, particularly in nonirradiated ileum. However, early complications indicate a learning curve, and long-term follow-up and larger data are needed.",
    "copyrights": "Copyright \u00a9 2012 Elsevier Inc. All rights reserved.",
    "doi": "10.1016/j.urology.2011.12.026",
    "journal": "Urology",
    "keywords": [],
    "methods": null,
    "publication_date": "2012-04-04",
    "pubmed_id": "22469584",
    "results": "In the early postoperative period, intestinal obstruction (2 cases), ureteroileal anastomotic leakage (3 cases) and vesico-ileocutaneous fistula (1 case) were encountered. No ureteroileal anastomotic obstruction or catherization-related difficulty was observed until the last follow-up (2 months to 3 years). Of 15 anastomoses, 14 were nonrefluxing.",
    "title": "Preliminary short-term outcomes of a modified double-T ileal continent cutaneous urinary diversion using Yang-Monti tube implantation through serosa-lined extramural tunnel: the PGIMER pouch.",
    "xml": "<Element 'PubmedArticle' at 0x7885042851c0>"
}