首页> 外国专利> SURGICAL METHOD FOR TREATING THE CASES OF EXTENSIVE INJURIES OR OBLITERATIONS OR MALIGNANT INJURIES IN LOWER URETER PORTION WITH URETEROCYSTOANASTOMOSIS

SURGICAL METHOD FOR TREATING THE CASES OF EXTENSIVE INJURIES OR OBLITERATIONS OR MALIGNANT INJURIES IN LOWER URETER PORTION WITH URETEROCYSTOANASTOMOSIS

机译:输尿管下裂合并输尿管下段广泛性损伤或梗阻或恶性肿瘤的手术方法

摘要

FIELD: medicine.;SUBSTANCE: method involves mobilizing a half of colon and rectum to expose ureters and posterior surface of the urinary bladder. Ureter mobilization and ureterolysis is carried out from renal pelvis to urinary bladder. The ureter is excised within the healthy tissue boundaries with ureter stump ligation following at the entry into the urinary bladder. The process extending to intramural ureter part, distal portion of the injured ureter is to be excised within the healthy tissue boundaries and a part of the urinary bladder is to be excised with urinary bladder wall being sutured by applying two-rowed interrupted sutures. Anterior and posterior urinary bladder wall is mobilized with right and left neurovascular fascicles being retained to cervix. Anterior urinary bladder wall is opened in transverse direction. Proximal ureter end is introduced through separate pierce in urinary bladder apex into its cavity with an excess of 1.5 cm. Ureterocystoanastomosis is created by fixing proximal ureter end from its lumen side. Ureter segment protruding into urinary bladder cavity is longitudinally cut within 1.0 cm limits with ureteral mucous membrane being additionally attached to the urinary bladder mucous membrane with ureteral invaginate, protruding into urinary bladder cavity, being created. Ureter wall is attached to urinary bladder mucous membrane with ureteral invaginate, protruding into urinary bladder cavity, being created. Ureter wall is attached to external urinary bladder wall with interrupted sutures. Polymer tube of internal diameter of 1-2 mm is introduced into the ureter from urinary bladder side, to renal pelvis. Urinary bladder body with its apex are moved into iliac region to eliminate ureter strain. Posterior surface and apex of the urinary bladder are attached to anterior surface of lumbar muscle. Draining tube is set in the urinary bladder. Ureter intubation tube is brought out with its fixation on urinary bladder wall. Urinary bladder wound is sutured. Body and apex of the urinary bladder are extraperitonized with moved parietal peritoneal flap created with ureterocystoanastomosis in iliac region on the opposite side with respect to urinary bladder attachment to lumbar muscle. The extraperitonized iliac region is drained from opposite iliac region.;EFFECT: recovered normal urine passage; eliminated ureterostoma; high reliability of ureterocystoanastomosis.;7 cl
机译:领域:医学。;实体:方法涉及动员一半的结肠和直肠以暴露输尿管和膀胱后表面。从肾盂到膀胱进行输尿管动员和输尿管溶解术。在进入膀胱后,通过输尿管残端结扎在健康组织边界内切除输尿管。该过程将延伸至壁内输尿管部分,在健康的组织边界内切除受伤的输尿管的远端部分,并通过应用两排间断缝合线缝合膀胱壁,切除一部分膀胱。动员膀胱前后壁,将左右神经血管束保留在子宫颈上。膀胱前壁在横向方向上打开。输尿管近端通过1.5厘米以上的尿道顶端单独穿刺插入其腔内。输尿管膀胱吻合症是通过从管腔侧固定输尿管近端而造成的。将伸入膀胱腔的输尿管段在1.0 cm的范围内纵向切割,同时将输尿管粘膜附加到输尿管无内陷的膀胱粘膜上,然后伸入膀胱腔。输尿管壁附着在输尿管内陷的膀胱粘膜上,并伸入膀胱腔。输尿管壁通过间断缝合线连接到膀胱外壁。将内径为1-2 mm的聚合物管从膀胱侧插入输尿管,直至肾盂。将具有其顶点的膀胱体移入骨区域,以消除输尿管拉伤。膀胱的后表面和顶点附着于腰肌的前表面。导尿管设置在膀胱中。输尿管插管固定在膀胱壁上。缝合膀胱伤口。相对于膀胱对腰肌的附着,通过移动的顶腹膜皮瓣使膀胱的身体和顶点腹膜外化,该腹膜皮瓣由在相对侧的c骨区域中的输尿管膀胱吻合术形成。腹膜外渗出的区从相对的opposite区排出。消除输尿管造口;输尿管囊吻合术的高可靠性。; 7 cl

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