الفهرس | Only 14 pages are availabe for public view |
Abstract Introduction: The use of small bowel for ureteral replacement was described as early as 1906. Since that time, several surgical procedures have been proposed to optimize the technique. Objectives : Evaluation of anew technique: ?The Reconfigured Antirefluxive Ileal Ureter?. In addition, the literature is reviewed for various surgical methods for ureteral replacement. Patients and Methods: In Mansoura Urology and Nephrology Center, 16 patients were candidate for ileal replacenment of the ureter. The technique involved isolation of 5 to 7.5 cm ileal segment, which was further subdivided into 2 or 3 equal parts. Paramesentric incision along the longitudinal axis of these segments followed by unfolding resulted in 12 to 18 cm. ileal strip. Tubularization of this strip led to the formation of an ileal tube with a suitable caliber. The latter was implanted into the bladder by submucosal (non refluxing) ileovesicostomy. The follow up was carried out on out patient clinic. Results: Mean follow up(R+(BSD was 27.5(R+(B13 months (range 342). Mean serum creatinine remained stable in all cases. Excretory urography and/or magnetic resonance urography showed excellent configuration of the substitute without evidence of dilatation or obstruction. Conclusion : The new technique offers certain distinct advantages. A short bowel segment is included with the consequent absence of metabolic complications. It allows construction of an ileal ureter with a suitable crosssectional diameter without the need for tailoring and makes possible the use of an antireflux technique. |