METHOD OF ORTHOTOPIC ILEOCYSTOPLASTY WITH INSUFFICIENT LENGTH OF MESENTERY OF SMALL INTESTINE

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to urology. Ileal intestine is removed in length of 60 cm at distance of 25 cm from the ileocecal angle. Anatomically determined most mobile edge of the intestinal wall is determined. Asymmetric detubulubirisation of an ileum segment is performed from a distal end turned cranially for 45 cm from the antimesenteric edge at 1 cm to the left to form a narrow left and wide right edges of the detubularized segment. Distal and proximal parts of narrow intestinal edge are combined and sutured longitudinally along anterior surface. Formed reservoir wall is inverted between leaf of mesentery posteriorly; free wide edges of detubularized segment are moved anterior and reduced in lesser pelvis. Prior to final closure of reservoir by trial traction, it is determined and approximated with urethra stump most easily brought wide edge of intestinal wall, with which anastomosis with urethra is applied, and by longitudinal closure of reservoir walls, a J-shaped reservoir is tightly formed.;EFFECT: method provides preventing and reducing early postoperative complications, recovering in the earliest postoperative periods of independent urination, that provides the earliest increase in the capacity of orthotopic neo-cyst, restoration of the urine retention quality and thus the most early rehabilitation of the patient, improved quality of life of the patients after operations related to bladder removal.;1 cl, 5 dwg, 2 ex