[New uretero-cystoneostomy in cystocecoplasties. Technique and results].
Ureteric reimplantations into an intestinal segment are frequently followed by early, secondary or late stenoses. In UCN, it is essential to perform atraumatic ureteric dissection followed by reimplantation of a short ureter well vascularized by a single superior pedicle, i.e. the simplest UCN, putting the least strain on the ureter both during creation of the diversion and during subsequent healing. The ileal segment of an ileocaecocystoplasty must extend above the right iliac vessels. It is open on the antimesenteric border and its distal border is stripped of a 3 mm band of mucosa. To reach its homologue, the left ureter passes underneath the common root of the sigmoid mesocolon. Each optimally shortened ureter is placed in and fixed to the start and the end of a longitudinal mucosal tunnel, about 3 cm long. The ileum is sutured as a cuff around the orifice of each ureter. A ureteric stent is left in place for a fortnight. The ileum is sutured to the right laterocaval retroperitoneal tissue. This UCN is simple and rapid to perform.
Rampal
M
M
Service d'Urologie, CHU Timone, Marseille.
Coulange
C
C
Truong
T T
TT
Jean
F
F
Lechevallier
E
E
D002432:Cecum / Q000601:surgery; D006801:Humans; D001743:Urinary Bladder / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*
Nouvelle urétéro-cystonéostomie dans les cystocaecoplasties. Technique et résultats.