Vastyan Attila M, Pinter Andrew B, Farkas Andrew P, Vajda Peter, Lantos Janos, Mehes Gabor, Roth Elizabeth
Department of Paediatrics, Faculty of Medicine, University of Pécs, Pécs, Hungary.
Urol Int. 2003;71(2):215-8. doi: 10.1159/000071851.
The aim of this study was to investigate the feasibility of seromuscular gastrocystoplasty (SGCP) in an animal model and to compare it to conventional gastrocystoplasty (CGCP).
CGCP and SGCP (using gastric segments without mucosa) were each performed in 6 dogs. In both procedures, two-thirds of the dome of the bladder were excised and the gastric segment anastomosed to the bladder remnant. Cystography, cystomanometry, measurements of urine pH, and gross and microscopic pathological studies were carried out preoperatively, and postoperatively, at 6 and 12 weeks.
All seromuscular gastric segments proved viable, and 6 weeks after the operation they were covered by a thin layer of transitional epithelium, which had gradually thickened by the end of the 12-week follow-up. There was no difference in bladder capacity and compliance between the two groups, however, fasting urinary pH values were higher (less acidic) in the SGCP group.
Stripping off the mucosa of the gastric segment appears to stop hydrochloric acid secretion, thereby lessening the possible risk of ulceration, perforation, dysuria-haematuria, metaplasia and malignancy. The uroepithelium overgrowth of the seromuscular gastric segments might provide a more physiological neo-bladder than when using full-thickness gastrocystoplasty.
本研究旨在探讨在动物模型中进行浆肌层胃膀胱扩大术（SGCP）的可行性，并将其与传统胃膀胱扩大术（CGCP）进行比较。
对6只犬分别实施CGCP和SGCP（使用无黏膜的胃段）。在两种手术中，均切除膀胱顶部的三分之二，并将胃段与膀胱残余部分吻合。在术前、术后6周和12周进行膀胱造影、膀胱测压、尿液pH值测量以及大体和显微镜病理研究。
所有浆肌层胃段均存活，术后6周被一层薄的移行上皮覆盖，到12周随访结束时逐渐增厚。两组之间膀胱容量和顺应性无差异，然而，SGCP组空腹时尿液pH值较高（酸性较低）。
去除胃段黏膜似乎可阻止盐酸分泌，从而降低溃疡、穿孔、排尿困难-血尿、化生和恶性肿瘤的可能风险。与使用全层胃膀胱扩大术相比，浆肌层胃段的尿路上皮过度生长可能提供更符合生理的新膀胱。
