Büyükünal S N, Kaner G, Celayir S
Department of Pediatric Surgery, Cerrahpasa Medical Faculty, University of Istanbul, Turkey.
J Pediatr Surg. 1989 Jun;24(6):586-9. doi: 10.1016/s0022-3468(89)80513-5.
The aim of this study was to find a new alternate method for bladder exstrophies with small capacity and inelasticity, and to resolve complications of other bladder augmentation techniques. In 50 Wistar albino rats, a large bladder defect was created excising at least one half of their original bladder, keeping the peritrigonal zone intact. In each rat, a 2.5 x 1-cm inferiorly based rectus abdominus muscle flap was prepared from the lower abdominal quadrant. This flap was then rotated to cover the bladder defect. The inner layer formed by the peritoneum was sutured to the edges of the bladder defect by 6-0 separate sutures. The post-operative radiologic and scintigraphic examination of the urinary system done at different intervals showed no difference from that of normal rats. The only observed disadvantage of this technique was the formation of calculi in the bladder in 8/50 rats in the late post-operative period. Post-mortem histopathologic investigations performed at different intervals showed the inner layer of the flap to be completely covered by the transitional urinary epithelium of the bladder. We think this technique is easy to perform, non-time-consuming, and has a low complication rate. It may be useful in infants with small, noncompliant, inelastic bladder exstrophies.
本研究的目的是找到一种针对容量小且缺乏弹性的膀胱外翻的新替代方法，并解决其他膀胱扩大术的并发症。在50只Wistar白化大鼠中，通过切除至少一半的原始膀胱创建了一个大的膀胱缺损，同时保持膀胱三角区完整。在每只大鼠中，从下腹部象限制备一块2.5×1厘米的下腹直肌肌瓣。然后将该肌瓣旋转以覆盖膀胱缺损。由腹膜形成的内层通过6-0单股缝线缝合到膀胱缺损的边缘。在不同时间间隔对泌尿系统进行的术后放射学和闪烁扫描检查显示与正常大鼠无异。该技术唯一观察到的缺点是术后晚期50只大鼠中有8只在膀胱中形成结石。在不同时间间隔进行的尸检组织病理学研究显示，肌瓣内层完全被膀胱的移行尿路上皮覆盖。我们认为该技术操作简便、不耗时且并发症发生率低。它可能对患有小而顺应性差、缺乏弹性的膀胱外翻的婴儿有用。
