[The results of orthotopic plastic reconstruction of the urinary bladder with gastric and iliac graft].

To compare the results of postoperative plastic reconstruction of the urinary bladder (PRUB) with gastric and iliac graft, we studied 205 patients (150 males, 73.2%; 55 females, 26.8% aged 23-72 years, mean age 62.1 +/- 0.5 years) who had undergone orthotopic PRUB. Artificial bladder was created in 26 (12.7%) patients of a stomach pedicle segment, in 174 (84.9%)--of a detubulated iliac segment, in 5 (2.4%)--of a sigmoid segment. Early and late postoperative complications in using small intestinal segment reached 14.0 and 10.4%, respectively, lethality being 2.6%; in using gastric segment made up 3.9 and 8.7%, respectively, lethal outcomes were absent. Patients after PRUB had neither disorders of acid-base balance nor defects in electrolytic balance of blood. Urodynamic parameters were close to physiological ones. Thus, satisfactory clinical and functional results of urinary bladder orthotopic reconstruction even in long-term follow-up confirm advantages of orthotopic reconstruction of the lower urinary tracts in diseases of the urinary bladder.

[Replacement of the urinary bladder by the stomach body].

In the period from 2001 through 2004 plasty of the urinary bladder was performed in 24 patients using a. et v. gastroepyploici dexter. Mean age of the patients (18 men and 6 women) was 58.2 years. Gastrocystoplasty in 18 patients was performed after radical cystectomy for urinary bladder cancer, in 6 patients for neurogenic and small urinary bladder. The authors' original modification with a complete transversal resection of the stomach body taken together with the lesser curvature was used in operations on 10 patients. Early postoperative complications developed in one patient, late ones--in two patients, there were no lethal outcomes. Positive functional results were noted in all patients within the terms of observations from 2 through 22 months. Good quality of life was noted in all of them.