Utilização do colon transverso para realização de derivação urinaria continente : estudo experimental comparando duas tecnicas

AUTOR(ES)
DATA DE PUBLICAÇÃO

2004

RESUMO

Radiation therapy is an important method to treat cases ofpelvic ma1iV lantneoplasia. The inconveniences of this technique are actinic cystitis and urinary fistu1aewhich can make impossible the use of the bladder as a reservoir. Severa! techniques for carrying out heterotopic urinary direction have been descnbed in the literature. The aim in this study was to compare different techniques of continence mechanisms in colonic reservoirs, using the Monti s procedure associated to the Abol-Eneim s technique (Technique I) compared to the intussusception technique (Technique TI) in dogs. Six dogs were used as a pilot group for the techniques standardization. In the experiment, ten dogs divided into two groups of five were used. The Technique I uses 20cm of detubularized transverse colon for reservoir construction, ttom which 2,Sem are used to the conduit construction, and the continence mechanism is achieved by the creation of a seromuscular tunnel. The other technique uses the same colon segmento ttom which 6cm are used for the intussusception. Afier the reservoir and conduit construction, the measures of the conduit were taken. Surgical time for each technique was compared, and the surgical procedures were assessed by means of urodynamic study carried out 30 days after surgery. The urodynamic parameters analyzed were the reservoir capacity, the maximum pressure of the reservoir, and the compliance. Afier the urodynamic evaluation, the dogs received anesthesia for the macroscopic and histological assessment of the reservoirs. Resuhs have shown that Technique I requires more surgical time; both of the techniques are complexes, and the continence mechanismis significantlymore efficient and the conduit is longer in the Technique I compared to the Technique TI.Histological findings on the reservoirs and ofthe conduit in the Technique TI presented features similar to the normal colon tissue. Inversion in the direction of the muscular layer fibers was observed in the conduct of the Technique I. In conclusion, the Technique I offers advantages in the efficacy of the continence mechanism, and presents longer conduit

ASSUNTO(S)

aparelho urinario cirurgia - tecnica bexiga urologia

ACESSO AO ARTIGO

Documentos Relacionados