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在回肠膀胱成形术中,使用带浆膜内衬槽的“戈内姆·阿博莱宁”技术将蒙蒂作为可控 continent 造口。

MONTI as continent catheterized stoma using serosal-lined trough "Ghoneim Abolenin" technique in ileocystoplasty.

作者信息

Sammour Mohammed T, Ajjaj Abdulbari Bin

机构信息

Department of Urology, King Abdul-Aziz National Guard Hospital, Al-Ahsa, Saudi Arabia.

出版信息

Urol Ann. 2011 Jan;3(1):33-5. doi: 10.4103/0974-7796.75863.

DOI:10.4103/0974-7796.75863
PMID:21346831
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3036998/
Abstract

It is a great challenge to select and perform continent mechanism in a stoma for urinary reservoir. A new technique by combining MONTI ileal conduit with the serosal lined trough in order to achieve continent catheterizable stoma to the umbilicus as a part of augmentation ileocystoplasty. We applied serosal-lined trough as a continent mechanism with MONTI ileal tube in 12 years smart girl underwent ileocystoplasty for neuropathic bladder due to meylomeningocele in whom continence failed to be achieved by using Mitrofanoff with submucosal tunnel of the bladder as continent mechanism before, also the previous operation included left to right transuretero-ureterostomy, ureterocystoplasty and reimplantation of the right ureter. The patient became completely continent; she was able to do self-catheterization easily through the umbilical stoma using 16-French catheter and was able to wash the mucous easily. The capacity of the augmented bladder was 300ccs. She became independent from her mother and stopped using diapers, anticholinergic and antibiotics. Combining MONTI conduit with serosal-lined extramural valve trough (The Ghoneim technique) is an effective continent technique and gives wider channel for catheterization and washing out the mucous.

摘要

在尿流改道的造口中选择并实施可控机制是一项巨大挑战。一种新技术是将MONTI回肠导管与浆膜内衬槽相结合,以实现经脐的可控性造口,作为扩大回肠膀胱术的一部分。我们将浆膜内衬槽作为可控机制与MONTI回肠管一起应用于一名12岁的聪明女孩,她因脊髓脊膜膨出导致神经源性膀胱而接受回肠膀胱术,此前使用带膀胱黏膜下隧道的Mitrofanoff作为可控机制未能实现控尿,且之前的手术包括左至右输尿管-输尿管吻合术、输尿管膀胱成形术和右侧输尿管再植术。该患者实现了完全控尿;她能够使用16号法国导管轻松地通过脐部造口进行自我导尿,并且能够轻松清洗黏液。扩大膀胱的容量为300cc。她变得不再依赖母亲,不再使用尿布、抗胆碱能药物和抗生素。将MONTI导管与浆膜内衬壁外瓣膜槽(戈内姆技术)相结合是一种有效的可控技术,可为导尿和冲洗黏液提供更宽的通道。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/834e/3036998/6f827a660283/UA-3-33-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/834e/3036998/b83e8a826103/UA-3-33-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/834e/3036998/1c49df66d4d0/UA-3-33-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/834e/3036998/6f827a660283/UA-3-33-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/834e/3036998/b83e8a826103/UA-3-33-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/834e/3036998/1c49df66d4d0/UA-3-33-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/834e/3036998/6f827a660283/UA-3-33-g003.jpg

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本文引用的文献

1
Serous lined extramural ileal valve: a new continent urinary outlet.浆膜内衬的壁外回肠瓣膜:一种新的大陆式尿路出口。
J Urol. 1999 Mar;161(3):786-91.
2
A technique for the creation of a continent cutaneous urinary outlet: the serous-lined extramural ileal valve.一种构建可控性皮肤尿路出口的技术:浆膜内衬的壁外回肠瓣。
Br J Urol. 1996 Nov;78(5):791-2. doi: 10.1046/j.1464-410x.1996.24426.x.
3
A novel uretero-ileal reimplantation technique: the serous lined extramural tunnel. A preliminary report.一种新型输尿管-回肠再植技术:浆膜内衬壁外隧道。初步报告。
J Urol. 1994 May;151(5):1193-7. doi: 10.1016/s0022-5347(17)35211-4.