| 摘要 |
FIELD: medicine. ^ SUBSTANCE: invention refers to medicine, and can be used in surgical creation of ureteroenteric anastomosis in external urine diversion through a segment of the small intestine. For creating the ureteroenteric anastomosis, a mesenteric pedicle segment of the small intestine 20 cm long is prepared. The ureter is transected above the defect level. A distal segment of the ureter is ligatured, and a proximal part is mobilised at 2 cm from a resection edge. A distal edge of the enteric segment in an isoperistaltic direction is anchored to the anterior abdominal wall. At a distance 0.4 cm from the resected edge of the enteric segment turned to the ureter, 4 equispaced holding sutures are applied through the entire wall layer. On the enteric mucosa, from its lumen at 2 cm from the resected edge, there is applied a circumferential purse-string suturing with its ends delivered outside through a wall puncture. Through the enterostoma, into the enteric lumen, drainage of diametre matched with the internal diametre of the ureter is introduced in the ureter, maximum close to a kidney. The equispaced holding sutures is circumferentially stitched to fix to the draniage wall and an edge of the resected ureter through the entire wall layer. All the holding sutures are fastened; the edges of the ureter and the small intestine are pulled together and fixed to the drainage drawn out from the enterostoma to invaginate the walls fixed thereto into the enteric lumen below the purse-string suture level. The ends of the purse-string suture are fastened to enable the invaginated walls with their opposed external surfaces to be tightly pressed to the intubation drainage. Below a compression suture line, on a serous-muscular layer of the small intestine, two semi-purse string sutures are applied. They are fixed to an adventitious tissue of the ureter, tightened and fastened. ^ EFFECT: method allows preventing postoperative ascending pyelonephritis, and reducing injures of the ureter. ^ 7 dwg, 1 ex |
