Kato T, Sato K, Miyazaki H, Sasaki S, Matsuo S, Moriyama M
Department of Urology, Akita University School of Medicine.
J Urol. 1993 Aug;150(2 Pt 1):326-31. doi: 10.1016/s0022-5347(17)35474-5.
With the current practice of continent urinary diversion the patient still has a cutaneous stoma and must perform intermittent catheterization. To circumvent these problems we devised the uretero-ileoceco-proctostomy (ileocecal rectal bladder), in which the intussuscepted ileocecal segment is interposed between the ureters and rectum, the rectal capacity is augmented by side-to-side anastomosis to the cecal limb of the segment and continence is controlled by the anal sphincter. The interposed segment prevents reflux of the urine-fecal mixture to the upper urinary tract and may decrease the risk of carcinoma at the ureteroileal anastomosis. The intussusception is stabilized without opening the recipient bowel (cecal limb), thus simplifying the subsequent ceco-proctostomy with automatic suture technique. Our preliminary experience in 18 patients with this new technique is encouraging with respect to voiding, preservation of renal function and quality of life.
在目前可控性尿流改道的实践中，患者仍有皮肤造口且必须进行间歇性导尿。为避免这些问题，我们设计了输尿管 - 回盲 - 直肠造口术（回盲直肠膀胱），其中套叠的回盲段置于输尿管和直肠之间，通过与该段盲肠支进行侧侧吻合来扩大直肠容量，并且通过肛门括约肌控制控尿。置入的肠段可防止尿粪混合物反流至上尿路，并可能降低输尿管回肠吻合口处发生癌变的风险。套叠无需打开接受肠段（盲肠支）即可固定，从而通过自动缝合技术简化了随后的盲肠 - 直肠造口术。我们对18例采用这种新技术的患者的初步经验在排尿、肾功能保留和生活质量方面令人鼓舞。
