Parra R O, Cummings J M, Boullier J A
Department of Surgery, St. Louis University School of Medicine, Missouri.
Urology. 1994 Jul;44(1):35-7. doi: 10.1016/s0090-4295(94)80006-5.
Despite the advantages offered by continent urinary diversion techniques, wide acceptance of the procedure has been hampered by the length of time required to detubularize and suture the reconfigured bowel. With the purpose of simplifying the procedure, a linear stapler loaded with absorbable staples was used to accomplish simultaneous detubularization and closure of the reservoirs.
Six patients, 4 men and 2 women received a stapled detubularized reservoir following radical cystectomy. The male patients all had construction of a neobladder, whereas in the females a catheterizable continent stoma was designed.
Operative time was shortened by an average of 30 to 45 minutes without technical difficulties. No postoperative complications related to the staple line occurred and with a follow-up of 6 months good functional results have been achieved, with no patient experiencing diurnal incontinence.
This simple mechanical detubularization technique offers results similar to the hand suture method while at the same time shortening and simplifying the procedure.
尽管可控性尿流改道术具有诸多优势，但该手术的广泛应用却因将肠管重新塑形所需的去管化和缝合时间而受到阻碍。为简化手术过程，采用装载可吸收吻合钉的线性吻合器来同时完成储尿囊的去管化和闭合。
6例患者，4例男性和2例女性，在根治性膀胱切除术后接受了吻合器去管化储尿囊手术。男性患者均构建了新膀胱，而女性患者则设计了可导尿的可控性造口。
手术时间平均缩短了30至45分钟，且无技术困难。未发生与吻合钉线相关的术后并发症，随访6个月取得了良好的功能结果，无患者出现日间尿失禁。
这种简单的机械去管化技术提供了与手工缝合方法相似的结果，同时缩短并简化了手术过程。
