[Clinical studies on the continent ileocecocolonic reservoir].
Continent urinary reservoir has recently been paid much attention by urologists for its contribution to improvement in quality of life in patients who are in need of urinary diversion. We, herein, present some preliminary result in the operation of continent ileocecocolonic (ICC) or ileocecal reservoir which was performed on 13 patients. Since several improvements have been made on the operative procedures for ICC reservoir, the most recent techniques are described below: A 20-25 cm of cecocolonic and 12 cm of terminal ileal segment were isolated after a full length mesenteric incision. The cecocolonic segment was longitudinally split open in 15-20 cm on its antimesenteric border to be re-configuration later. The mesentery was detached for 8 cm in the terminal ileum which was randomly incised into its seromuscular layer. Following the intussusception of the terminal ileum into the cecal lumen, the nipple valve of the ileum was stabilized by three row-staples and two row-paired nonabsorbable sutures. The valve was re-enforced by nonabsorbable sutures and dacron mesh which were placed at the base of the intussusception. The ureter was implanted in the tenia of the colon with antireflux technique of the submucosa tunnel. The distal end of the split cecocolonic segment was, the, folded to and sutured with its proximal end, making a Heineke-Mikulicz type of re-configuration reservoir. A flush type of stoma was constructed, with dacron mesh placed around the ileum which was fixed to the rectus muscle and its anterior sheath.(ABSTRACT TRUNCATED AT 250 WORDS)
Tsukamoto
T
T
Kumamoto
Y
Y
Hirose
T
T
Omura
K
K
Takagi
Y
Y
D000328:Adult; D003106:Colon / Q000601:surgery; D006801:Humans; D007082:Ileum / Q000601:surgery; D008875:Middle Aged; D014523:Urethral Neoplasms / Q000601:surgery; D001749:Urinary Bladder Neoplasms / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*