INVERTING ORTHOTOPIC ILEOCYSTOPLASTY TECHNIQUE IN SHORT MESOILEUM

摘要

FIELD: medicine.;SUBSTANCE: invention refers to medicine, urology and can be used for treatment of the patients underwent cystectomy. An orthotopic intestinal U-reservoir of low pressure is formed of ileum. Herewith 55 cm of ileum is resected at a distance of 20-25 cm from ileocecal angle. The resected ileum is dissected along antimesentric edge throughout 40 cm. An afferent limb is preserved throughout 15 cm. A split part is folded symmetrically U-like so that an apex of U is directed caudad and maximally close to urethra stump. The adjoining edges are sutured. The opposite long sides are aligned so that ensuring a tube U-reservoir to be closed. The formed reservoir is turned out and unrolled in small pelvis between leaves of mesentery. It is unrolled so that posterior wall of the reservoir free from mesentery is arranged anteriad and its free pull-through in small pelvis additionally reduces the distance to stump of urethra by 3-4 cm. In low point of the reservoir, anastomosis with urethra is formed. Stented ureters are anastomosed with upper edge of afferent limb by the reflux technique. Ureteral stents are delivered outside through the reservoir along urethra. Inversely in neocyst cavity, a Foley's catheter is applied. The technique is simple and reliable; allows reducing surgically injured regions, avoiding conversion with applying more complex and expensive techniques of derivation in short mesoileum.;EFFECT: besides the technique ensures maximum life quality of the patients underwent cystectomy, reduces risk of complications due to pull-through of low point of the reservoir in small pelvis, forming antireflux protection.;10 dwg, 2 ex