Abol-Enein H, Ghoneim M A
Urology and Nephrology Center, Mansoura University, Egypt.
J Urol. 1999 Mar;161(3):786-91.
We report the functional results following the use of serous lined extramural valve as an antireflux technique and urinary outlet for continent urinary diversion.
The procedure was performed in 18 men and 5 women. The technique entails fashioning 2 serous lined extramural troughs in a detubularized W-shape ileal reservoir. A tapered ileal segment is embedded in 1 trough as an antireflux valve and the ureters are anastomosed to its proximal end. Another tapered ileal segment or the appendix is embedded in the second trough and acts as a continent cutaneous outlet.
No operative or postoperative mortality was observed. One patient had prolonged ileus which was treated conservatively. All patients were evaluable with a mean followup of 19 months. All patients but 1 were continent day and night. No catheterization difficulties were reported. Evacuation intervals were 4 to 5 hours. Radiographic evaluation demonstrated a continent compliant reservoir, stable and straight outlet, and absence of pouch and ureteral reflux.
This procedure is technically feasible, surgically versatile, applicable for urinary diversion or conversion and associated with satisfactory outcome.
我们报告使用带浆膜的壁外瓣膜作为抗反流技术和可控性尿流改道术的尿液出口后的功能结果。
该手术在18名男性和5名女性中进行。该技术需要在去管化的W形回肠储尿囊中制作2个带浆膜的壁外槽。将一段锥形回肠段嵌入其中一个槽作为抗反流瓣膜，输尿管与其近端吻合。另一段锥形回肠段或阑尾嵌入第二个槽并作为可控性皮肤出口。
未观察到手术或术后死亡。1例患者出现肠梗阻延长，经保守治疗。所有患者均可评估，平均随访19个月。除1例患者外，所有患者日夜均能自控排尿。未报告导尿困难。排空间隔为4至5小时。影像学评估显示储尿囊顺应性良好、出口稳定且笔直，无储尿囊和输尿管反流。
该手术在技术上可行，手术方式多样，适用于尿流改道或转换，且结果令人满意。
