Srpski arhiv za celokupno lekarstvo 2011 Volume 139, Issue 7-8, Pages: 491-495
https://doi.org/10.2298/SARH1108491S
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Results of the modification of antireflux subserosal and submucosal implantation of the ureter into the rectosigmoid urinary reservoir after total cystectomy
Stojković Ivica (Urološka klinika, Klinički centar, Niš)
Ignjatović Ivan (Urološka klinika, Klinički centar, Niš)
Bašić Dragoslav (Urološka klinika, Klinički centar, Niš)
Introduction. Uretero-intestinal anastomisis has a large influence on
derivation quality. Objective. The aim of the study was to present the
modified serous lined extramural Abol-Enein method of implantation of low
quality ureter into the sigma-rectum pouch and comparison of the results with
Le Duc implantation. Methods. From 1995 to 2009, 62 dilated ureter units were
implanted in the detubularized rectosigmoid urinary reservoir. In 28 units Le
Duc, and in 34 Abol-Enein method was done. Urinary fistula and ileus were
considered as early complications, while late complications included stenosis
and reflux pyelonephritis. Frequency of urination was considered as a
parameter of functionality. Results. Transitory urine fistulae occurred only
in the ureters implanted according to Le Duc technique in 4/28 (14.2%); the
difference between the examined groups was close but still below the level of
statistical significance (p=0.07). Ileus occurred with nearly equal frequency
in both groups. Stenosis on the ureteral implantation place was significantly
more frequent (p=0.04) in the Le Duc group 5/28 (21.7%) than in the
Abol-Enein group 0/34 (0%). Refluxive pyelonephritis occurred in 3/34 (8.8%)
of the Abol-Enein group, and in 5/28 (21.7%) of patients in the Le Duc group.
Concerning the daily frequency, there was no difference between the examined
groups. Conclusion. Uretero-intestinal anastomisis of dilated ureters through
a serous-lined extramural tunnel decreases the risk of reflux in a
considerable number of patients, with an acceptable level of complications.
There are several advantages in comparison with Le Duc method.
Keywords: dilated ureter, Mainz Pouch II, ureterosigmoidostomy
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