A clinical study of enhanced continent mechanism of tapered ileum by extramural support from pouch-abdominal wall
- VernacularTitle:贮尿囊与腹壁的壁外支持增强缩窄回肠控制机制的临床研究
- Author:
Yuemin XU
;
Youzhang XU
;
Yong QIAO
- Publication Type:Journal Article
- Keywords:
Urinary diversion;
Continent reservoirs,Tapered ileum
- From:
Chinese Journal of Urology
2001;0(09):-
- CountryChina
- Language:Chinese
-
Abstract:
Objective To construct a reliable continent tube, which is easy to catheterize and is surgically simple. Methods 10 patients with bladder cancer underwent a procedure in which ileal segment was tapered as an efferent tube,a part of which was placed between the back surface of the rectus muscle and wall of the ileal pouch. Internal orifice of the tapered ileum was anastomosed to the ileal pouch and external orifice of the tapered ileum was anastomosed to umbilicus. Urodynamic and radiological studies were carried out postoperatively on 9 patients. Results The stoma could be easily catheterized with a 16 F catheter in all the patients. One patient died of heart disease 55 days postoperatively. In the other 9 patients, 8 were completely continent day and night. The urodynamic study of the efferent tubes showed a maximum close pressure with a full pouch was significantly higher than those with an empty pouch (t=-7.14,P=0.000098 ). Retrograde radiogram of the efferent tubes showed perfect canalization without stenosis. Conclusion This study suggested that the continent mechanism of tapered ileum can be greatly enhanced by fixing it between the abdominal and the pouch wall,allowing also easy catheterization and surgical simplicity.
