Bourdelat D, Vrsansky P, Gruel Y, Babut J M
Service de Chirurgie Pédiatrique, Hôpital Delafontaine, Saint-Denis.
Ann Urol (Paris). 1996;30(2):76-84.
To determine the usefulness of antral bladder controlled by the pyloric sphincter denervated for urological applications, bladder replacement was performed in 17 dogs using the antral segment with its own sphincter, initially with the pylorus supplied by the left gastro-epiploic artery, and later by the right gastro-epiploic artery. The smooth pyloric muscle was denervated to obtain permanent spasm and pulled through the striated anterior abdominal muscle. Both ureters were anastomosed by a Cohen's procedure. The best results were obtained with a gastric pouch supplied by the right gastro-epiploic artery; dissection and reimplantation of the ureters in the gastric wall are difficult. IVP and cystography indicated good function of the antral pouch, with no reflux. The antral bladder controlled by the denervated pyloric sphincter could be a possible alternative in the surgical management of neurogenic or exstrophic bladder.
为确定去神经支配的幽门括约肌控制的胃窦膀胱在泌尿外科应用中的实用性，对17只犬进行膀胱替代术，采用带有自身括约肌的胃窦段，最初由胃网膜左动脉供血，后来由胃网膜右动脉供血。去除幽门平滑肌的神经以使其永久痉挛，并将其穿过横纹肌的腹前壁肌肉。两条输尿管均通过科恩手术进行吻合。由胃网膜右动脉供血的胃小囊效果最佳；输尿管在胃壁的解剖和再植很困难。静脉肾盂造影和膀胱造影显示胃窦小囊功能良好，无反流。去神经支配的幽门括约肌控制的胃窦膀胱可能是神经源性或膀胱外翻手术治疗的一种替代方法。
