| 摘要 |
FIELD: medicine, oncology. ^ SUBSTANCE: the present innovation deals with orthotopic plasty of urinary bladder after cystectomy. It is necessary to carry out cystectomy, cut a flap out of gastric body due to resecting greater curvature, suture in gastric defect, transpose the flap obtained into small pelvis to form an urinary reservoir and implant ureters into it; then the reservoir should be anastomosed with urethra, moreover, the flap should be cut out by resecting greater curvature of stomach together with adjacent departments of its anterior and posterior wall from cardial gastric department up to pyloric one at about 5-7 cm against pyloric sphincter. Flap's length corresponds to 20 cm, not less. Transplant should be descended into small pelvis so, that greater curvature to be the posterior wall of the reservoir formed. It is important to fix reservoir's mesentery towards parietal peritoneum., Inferior third of the flap should be folded upwards to suture its edges with those of the middle third of the transplant. One should finish the formation of closed reservoir of spherical shape due to suturing in the remained defect so, that all the lines of sutures to be at anterior wall of the reservoir developed being as an "inverted" letter "Y". In distal part of the cupula of the developed reservoir one should form a separate foramen being beyond the area of sutures to use it for applying reservoir-urethral anastomosis. The innovation enables to develop spherical low-pressure urinary reservoir that decreases the risk of vesico-ureteral reflux, frequency of urination and enuresis. ^ EFFECT: higher efficiency of therapy. ^ 4 dwg, 1 ex |
