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首页> 外文期刊>International journal of urology: official journal of the Japanese Urological Association >Results of the ureteral reimplantation with serous-lined extramural tunnel in orthotopic ileal W-neobladder.
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Results of the ureteral reimplantation with serous-lined extramural tunnel in orthotopic ileal W-neobladder.

机译：输尿管原位回肠W-needoblader的浆膜衬里壁外隧道输尿管再植的结果。

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BACKGROUND: Our experience in uretero-ileal anastomosis using the serous-lined extramural tunnel in orthotopic ileal W-neobladder is presented. METHODS: Between June 1998 and November 2001, 42 patients (40 men and two women) underwent radical cystectomy and orthotopic ileal neobladder for invasive bladder cancer. The ureters were reimplanted into serous-lined extramural tunnels as described by Abol-Enein and Ghoneim. However, we made minor modifications during the ureteral reimplantation in cases that necessitated distal ureteral excision and with grossly dilated ureters. Evaluation included clinical and radiographic studies to determine functional and oncological outcomes. RESULTS: There was no operative mortality. The mean follow-up period was 28 months (range 12-52). Early complications occurred in four patients (9.5%). An endarterectomy for acute popliteal arterial embolism, the excision of the pouchointestinal fistula and a temporary colostomy were performed in two of these four patients. The other two patients were treated conservatively. Late complications occurred in eight patients (19%). Reflux was observed in three renal units (3.7%), ureterointestinal strictures in another three renal units (3.7%) and urethroileal stenosis in two patients (4.8%). In all cases, stabilization or improvement of renal function was achieved. No metabolic complications were observed. CONCLUSIONS: Ileal W-neobladder with a serous-lined extramural tunnel is a safe, reliable form of lower urinary tract reconstruction. The method can be carried out with equal ease in grossly dilated ureters and in cases that necessitate distal ureteral excision.
机译：背景：我们的经验在输尿管回肠吻合术中使用浆膜衬里的壁外隧道在原位回肠W型膀胱中。方法：在1998年6月至2001年11月之间，对42例患者（40例男性和2例女性）进行了根治性膀胱切除术和原位回肠新膀胱治疗浸润性膀胱癌。如Abol-Enein和Ghoneim所述，将输尿管重新植入浆膜衬里的壁外隧道。但是，在需要远端输尿管切除和输尿管扩张的情况下，我们在输尿管再植期间做了一些小的改动。评估包括临床和放射学研究以确定功能和肿瘤学结果。结果：无手术死亡。平均随访期为28个月（范围12-52）。早期并发症发生在四名患者（9.5％）中。在这四名患者中的两名患者中进行了急性pop动脉栓塞的内膜切除术，袋肠瘘的切除和临时结肠造口术。另外两名患者接受了保守治疗。晚期并发症发生于八名患者（19％）。在三个肾单位（3.7％）中观察到反流，在另外三个肾单位（3.7％）中观察到输尿管肠狭窄，在两个患者中（4.8％）观察到尿道狭窄。在所有情况下，肾功能均得以稳定或改善。没有观察到代谢并发症。结论：带有浆膜衬里的壁外隧道的回肠W型膀胱是下尿路重建的一种安全，可靠的形式。该方法可以在粗大的输尿管中以及需要远端输尿管切除的情况下轻松进行。

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