Viability and functional characteristics of enterocystoplasty after ligation of the vascular pedicle.
A canine model was developed to evaluate the effect of ligation of the mesenteric blood supply of enterocystoplasty. In 5 dogs with an ileocystoplasty and 6 with a gastrocystoplasty the blood supply was interrupted 4 months postoperatively. Re-exploration 2 to 8 weeks later revealed sufficient collateral blood flow to maintain integrity of the bowel wall and none of the animals had urine leak or other signs of perforation. Two animals had a significant decrease in the size of the cystoplasty. Intraoperative measurements of bowel viability after pedicle ligation were not predictive of the outcome. The functional outcome after pedicle division seems to be variable and probably reflects how well the patch has been vascularized before interruption of the blood supply. The augmented bladder may remain viable if sufficient time has elapsed to allow revascularization of the intestinal segment before its mesenteric blood supply is divided.
St Clair
S R
SR
Department of Urology, Joint Military Medical Command, Wilford Hall USAF Medical Center, San Antonio, Texas.
Ritchey
M L
ML
Hansberry
K
K
Hixson
C J
CJ
D000818:Animals; D003097:Collateral Circulation; D004285:Dogs; D005260:Female; D005500:Follow-Up Studies; D007082:Ileum / Q000098:blood supply* / Q000601:surgery; D008026:Ligation / Q000009:adverse effects; D008638:Mesenteric Arteries; D016343:Monitoring, Intraoperative; D011706:Pyloric Antrum / Q000098:blood supply* / Q000601:surgery; D001743:Urinary Bladder / Q000502:physiology* / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods