METHOD OF HETEROTOPIC SMALL INTESTINAL PLASTICS OF URINARY NEOBLADDER

摘要

FIELD: medicine.;SUBSTANCE: invention relates to medicine, namely to surgery and urology, oncourology, and can be used in heterotopic small intestinal plastics of urinary neobladder of low intraluminal pressure from an isolated W-shaped ileal segment. For this, the proximal and distal sections of the segment are left non-detubularized, of 10 cm each. Two sections of the intestine of 20 cm, located between them, are opened by dissecting the intestine along the antimesenteric margin. Then sew the posterior walls of the intestine with a single-row nodular suture. Formation of the reservoir begins with the cross-linking of the facing edges of the dissected intestine in a state of moderate tension along the length and width with a continuous suture of a absorbable stitch. Front wall of the reservoir is formed with ureter implantation. For this, the distal ends of the ureters are superimposed in the distal non-detubularized region, with the application of antireflux vesicoureteral anastomoses. When the stoma is formed, the end of the proximal non-detubularized portion is withdrawn through the incision in the left ileal region.;EFFECT: method provides an improvement in the quality of life of patients due to the formation of bladder of sufficient capacity, as well as a reduction in the number of complications in the long-term postoperative period due to a change in the shape of the urinary reservoir from the cylindrical to the globular in a rather early postoperative period, reduction in the risk of trophic ureteric wall disruption, which reduces the risk of complications such as failure of uretero-intestinal anastomoses, and also excludes vesicoureteral reflux.;1 cl, 7 dwg, 2 ex