rpmjResearch'n Practical Medicine JournalResearch and Practical Medicine Journal2410-1893"QUASAR", LLC10.17709/2409-2231-2020-7-2-10rpmj-544Research ArticleОбзорыReviewМетодики формирования неоцистуретроанастомоза при ортотопической пластике мочевого пузыря после радикальной цистэктомииMethods of neocystourethroanastomosis formation in orthotopic bladder plastic surgery after radical cystectomyhttps://orcid.org/0000-0001-5346-3285КозловаП. С.KozlovaP. S.

Козлова Полина Сергеевна – студентка 5 курса факультета фундаментальной медицины

119991, г. Москва, Ломоносовский пр-т, д. 27, корп. 1

 

Polina S. Kozlova – 5th-year student of the Faculty of fundamental medicine

3 2nd Botkinskiy travel, Moscow 125284

https://orcid.org/0000-0002-4171-6211НюшкоК. М.NyushkoK. M.

Нюшко Кирилл Михайлович – кандидат медицинских наук, ведущий научный сотрудник отделения онкоурологии

125284, г. Москва, 2-й Боткинский проезд, д. 3

SPIN: 7162-5527

AuthorID: 651466

Kirill M. Nyushko – Cand. Sci. (Med.), leading researcher of the oncourology Department

27/1 Lomonosov ave., Moscow, 119991

SPIN: 7162-5527

AuthorID: 651466

kirandja@yandex.ruГорбачВ. А.GorbachV. A.

Горбач Владимир Александрович – заместитель генерального директора по науке

683002, г. Петропавловск-Камчатский, Северо-Восточное шоссе, 30, а/я 56

SPIN: 8008-2449

AuthorID: 165392

Vladimir A. Gorbach – Deputy General Director for science

30, Severo-Vostochnoe Shosse, a/ya 56, Petropavlovsk-Kamchatsky, 683002

SPIN: 8008-2449

AuthorID: 165392

АлексеевБ. Я.AlekseevB. Ya.

Алексеев Борис Яковлевич – доктор медицинских наук, профессор, заместитель генерального директора по науке

125284, г. Москва, 2-й Боткинский проезд, д. 3

SPIN: 4692-5705

AuthorID: 651796

Boris Ya. Alekseev – Dr. Sci. (Med.), Professor, Deputy General Director for science

3 2nd Botkinskiy travel, Moscow 125284

SPIN: 4692-5705

AuthorID: 651796

Московский государственный университет им. М.В.ЛомоносоваРоссияP.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological CentreRussian FederationМНИОИ им. П.А.Герцена – филиал ФГБУ «Национальный медицинский исследовательский центр радиологии» Министерства здравоохранения Российской ФедерацииРоссияP.A.Hertsen Moscow Oncology Research Institute – Branch of the National Medical Research Radiological CentreRussian FederationНаучно-исследовательский геотехнологический центр Дальневосточного отделения Российской академии наукРоссияScientific Research Geotechnological Centre Far Eastern Branch of Russian Academy of SciencesRussian Federation20202406202072109115Copyright © Козлова П.С., Нюшко К.М., Горбач В.А., Алексеев Б.Я., 20202020Козлова П.С., Нюшко К.М., Горбач В.А., Алексеев Б.Я.Kozlova P.S., Nyushko K.M., Gorbach V.A., Alekseev B.Y.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpmj.ru/rpmj/article/view/544

 В данном обзоре литературы описаны различные хирургические методики, позволяющие снизить вероятность развития недержания мочи после ортотопической пластики мочевого пузыря по Штудеру. Удовлетворительное удержание мочи возможно при сохранении максимальной длины уретры, состоятельности везико-уретрального анастомоза, достаточном объеме неоцистиса с низким давлением, а также функциональной и морфологической адаптации стенки кишки. Рассмотрены методики, способствующие снижению натяжения в области везико-уретрального анастомоза и давления при короткой брыжейке, сохранению функциональной длины уретры с помощью «вторичного сфинктера», уделено внимание некоторым особенностям выделения сегмента подвздошной кишки достаточной длины для формирования неоцистиса удовлетворительного объема, выполнения неоцистуретроанастомоза во время робот-ассистированной цистопластики, рассмотрены сравнение хирургических методик, а также возможная целесообразность использования шовного материала V‑loc. Описан модифицированный способ формирования робот-ассистированного анастомоза для лапароскопических операций. Представлены результаты клинических исследований, в одном из которых рассмотрены результаты модификации техники «non-hole», а в другом — метод временного натяжения зоны анастомоза. Описан опыт формирования везико-уретрального анастомоза с помощью сшивающего аппарата CAPIO, а также опыт реконструкции фасции Денонвилье интраоперационно. Упомянуто искусственное приспособление, использующееся для достижения удержания мочи: искусственный сфинктер мочевого пузыря (AUS).

This literature review describes various surgical techniques that reduce the urinary incontinence chance after orthotopic plastic surgery of the bladder by Studer. Satisfactory retention of urine is possible in case of maintaining the maximum length of the urethra, consistency of vesico-urethral anastomosis, sufficient volume of neocystis with low pressure, as well as functional and morphological adaptation of the intestinal wall. The techniques that help to reduce tension in the region of the vesico-urethral anastomosis and pressure in a short mesentery, preservation of functional urethral length by "secondary sphincter" using, attention is paid to some exposure characteristics of the ileum segment of sufficient length for the formation of neocities a satisfactory amount of, performing neotestamentaria during robot-assisted of cystoplasty, comparing the surgical techniques, as well as possible the feasibility of using suture V‑loc. A modified method for forming a robot-assisted anastomosis for laparoscopic operations is described. The results of clinical studies are presented, in one of which the results of modification of the "non-hole" technique are considered, and in the other — the method of temporary tension of the anastomosis zone. The article describes the experience of forming a vesico-urethral anastomosis using a CAPIO cross-linking device, as well as the experience of reconstructing The denonvillier fascia intraoperatively. An artificial device to achieve urinary retention: the artificial urinary sphincter (AUS).

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The authors declare that there are no conflicts of interest present.