Optimization of uretero-intestinal anastomosis in urinary diversion: an experimental study in dogs. III. A new antireflux technique for uretero-ileal anastomosis: a serous-lined extramural tunnel.
A new antireflux uretero-ileal reimplantation technique suitable for use with bladder substitutes is presented. This procedure entails creation of a serous-lined extramural tunnel. Following detubularization of the bowel segment, the adjacent flaps are approximated by continuous 4/0 non-absorbable sutures 1.5 cm from the cut edges. The ureters are laid in the trough thus fashioned. "Button-holes" are created in the bowel flaps and a mucosa-to-mucosa uretero-ileal anastomosis is carried out. The mucosal edges of the flaps are then approximated by one layer of continuous 4/0 (PGA) suture resulting in closure of this artificial tunnel. The feasibility and functional outcome of this technique were experimentally investigated in 8 dogs. Follow-up was carried out up to 30 weeks. Assessment by intravenous urography and ascending studies showed that the procedure is an efficient method of providing an unobstructed unidirectional flow of urine.
Department of Urology, Urology-Nephrology Centre, Mansoura, Egypt.
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Abol-Enein
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MA
Ghoneim
D000818:Animals; D003251:Constriction, Pathologic / Q000209:etiology / Q000517:prevention & control; D004285:Dogs; D005069:Evaluation Studies as Topic; D007082:Ileum / Q000473:pathology / Q000601:surgery*; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D014513:Ureter / Q000473:pathology / Q000601:surgery*; D014547:Urinary Diversion / Q000009:adverse effects / Q000379:methods*; D016476:Urinary Reservoirs, Continent / Q000009:adverse effects / Q000379:methods; D014718:Vesico-Ureteral Reflux / Q000209:etiology / Q000517:prevention & control