[Forming of straight urointestinal anastomosis at enteric replacement of urinary bladder].
Problem of decreasing the complications rate of intestinal urine derivation is very relevant. One of the most important problem is the stricture of urointestinal anastomosis. The problem of the choice of antireflux or direct method of ureters implantanion is not solved. Results of forming of 186 renoureteral units (RUU) according to direct method and 70 RUU according to antireflux method were analyzed by the authors. Straight anastomosis was applied according to Wallace 1 and 2 technique, antireflux--according to Abol-Enein technique or by means of transverse duplicating. Age of the patients ranged from 16 to 76 years (56 years on average); men prevailed in groups. Terms of supervision ranged from 6 to 108 months (54.6 months on average). Strictures and failure of ureteroreservoir anastomosis using Wallace method were not revealed (0%), then using antireflux methods (transverse duplicating or extramural Abol-Enein tunnel) the frequency of complication amounted 2.8% on average. Strictures after antireflux mode in case of their early exposure were successfully corrected using endoscopic methods. In other cases open revision of anastomoses with their repeated apply was carried out. Reno-reservoir reflux was not observed in any cases after antireflux methods. Clinical manifestation of reflux was revealed at 2 RUU. Basing on the data renal radionuclide of image renal function didn't significantly change after direct or antireflux methods of ureters implantation. Wallace method is remarkable for its technical usability. This method ensures low level of complications after as incontinent and continent urine derivation.
Darenkov
S P
SP
Ochcharkhadzhiev
S B
SB
D000293:Adolescent; D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods; D015653:Cystectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007082:Ileum / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013536:Suture Techniques; D013997:Time Factors; D016896:Treatment Outcome; D014513:Ureter / Q000601:surgery*; D001745:Urinary Bladder Diseases / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D055815:Young Adult