输出管悬吊增强缩窄回肠控制机制的实验研究

Enhanced continent mechanism of tapered ileum by suspension technique

目的 设计控制可靠、导尿容易、并发症少的可控性膀胱输出道的手术方法。 方法 对 8条成年杂种狗采用经裁剪后缩小管腔直径的回肠作为输出管 ,用宽 1.5cm的涤纶带以 40 0 g的拉力将输出管固定于腹直肌上。术后 12周作尿动力学和X线检查。 结果 8条狗的腹壁造口可容易地插入 14F导管。尿动力学检查示膀胱输出管最大闭合压为 117～ 15 7cmH2 O ,平均 137cmH2 O。腹壁造口逆行造影示输出管被固定在腹壁下 ,无狭窄 ,膀胱造影示输出管内无造影剂。

Objective To construct a reliable and continent urinary reservoir,which is surgically simple. Methods (8 adult mongrel female dogs underwent a procedure in which an ileal segment was tapered as an efferent tube and a 1.5 cm in width of Dilurn polyester with a tension of 400g was used to suspend the efferent tube to enhanced the continent mechanism of the tapered ileum.) Urodynamic and radiological studies were carried out postoperatively in all. Results All the stomas could be easily catheterized with a 14 F catheter. The urodynamic study of the efferent tubes showed the maximum close pressure ranged from 117 cmH 2O to 157 cmH 2O,with a mean of 137 cmH 2O.Retrograde radiogram showed perfect canalization of the efferent tube without stenosis and pouchgram revealed no contrast medium in the efferent tube. Conclusions This study suggested that the continent mechanism of tapered ileum can be greatly enhanced by the suspension technique.