Bladou F, Houvenaeghel G, Rossi D, Serment G, Guerinel G, Delpero J R
Département de Chirurgie, Institut Paoli-Calmettes, Marseille.
Prog Urol. 1996 Apr;6(2):217-25.
To describe the technique and present the results obtained with the Miami reservoir, a continent urinary diversion, after pelvic exenteration for advanced gynaecological tumours.
A Miami reservoir was performed in 12 patients between January 1993 and January 1995. A detubed right colonic reservoir was created using automatic resorbable staples. The ureters were reimplanted into the reservoir using an anti-reflux system and continence was ensured by forming a tube with the terminal loop of ileum and by using a Bauhin valve, which can be reinforced when it is incompetent. Regular postoperative follow-up was conducted (6 to 26 months) with monitoring of laboratory parameters, intravenous urography, opacification of the reservoir, urodynamic assessment of the continent diversion.
There were no surgical complications related to the urinary diversion. Urinary continence was obtained in every case and after medical treatment of residual peristaltic contractions of the detubed colonic reservoir in 2 patients. Protection of the upper urinary tract was satisfactory after 2 years of follow-up, without stenosis or reflux of the uretero-colonic anastomoses. The mean capacity of the colonic reservoir was 465.5 +/- 101 ml at 6 months, with filling pressures lower than 20 cm H2O.
The Miami reservoir is a continent urinary diversion which is relatively easy to perform and reliable in terms of continence and protection of upper tract. However, a longer postoperative follow-up is required. The quality of life of young patients after pelvic exenteration is improved due to this type of contingent diversion which avoids the need for an abdominal urine collector, although it requires intermittent self-catheterization.
描述迈阿密贮尿囊（一种可控性尿流改道术）的技术，并展示在晚期妇科肿瘤盆腔脏器清除术后使用该贮尿囊所获得的结果。
1993年1月至1995年1月期间，对12例患者实施了迈阿密贮尿囊手术。使用自动可吸收吻合器制作一个去管化的右结肠贮尿囊。采用抗反流系统将输尿管重新植入贮尿囊，并通过用回肠终末袢形成一个管道以及使用鲍欣瓣来确保控尿，当鲍欣瓣功能不全时可对其进行加固。术后进行定期随访（6至26个月），监测实验室参数、静脉肾盂造影、贮尿囊显影、对可控性尿流改道进行尿动力学评估。
未发生与尿流改道相关的手术并发症。每例患者均实现了控尿，2例患者在对去管化结肠贮尿囊残留蠕动收缩进行药物治疗后也实现了控尿。随访2年后，上尿路的保护情况令人满意，输尿管 - 结肠吻合口无狭窄或反流。结肠贮尿囊在6个月时的平均容量为465.5±101毫升，充盈压力低于20厘米水柱。
迈阿密贮尿囊是一种可控性尿流改道术，实施相对容易，在控尿和上尿路保护方面可靠。然而，需要更长时间的术后随访。盆腔脏器清除术后年轻患者的生活质量因这种临时性尿流改道方式而得到改善，因为它避免了使用腹部集尿器的需要，尽管需要间歇性自我导尿。
