Bladder augmentation with an omental pedicled gastric seromuscular flap without the necessity of gastric resection.
Urol Res
; 32(4): 298-303, 2004 Aug.
Article
en En
| MEDLINE
| ID: mdl-15103430
ABSTRACT
Bladder augmentation using gastrointestinal segments requires gastric or intestinal resection. This has several risks. In a rat model, we aimed to test the efficacy of a new procedure in which a gastric seromuscular (GSM) flap is separated from the gastric mucosa without the necessity of gastric resection, and this GSM flap, based on an omentum pedicle, is transferred to the bladder. A GSM flap based on an omental leaf was dissected from the gastric mucosa and rotated 180 degrees counter-clockwise, after ligation of the vessels relating to the omentum, until the mid-duodenum. After urodynamic analysis for control levels of bladder capacity and pressure, the GSM flap was anastomosed to the bladder with a continuous suture. Because four rats died due to bladder calculi, only 21 of 25 rats were killed at 1 month (n = 10) and 4 months (n = 11) for histopathological and urodynamic evaluations of the augmented bladder. Bladder capacity increased significantly in the augmented bladders compared to preaugmentation (P < 0.001). There was no significant difference between end-filling pressures of the augmented bladders and preaugmentation. Histopathological findings demonstrated that the muscular surface of the flap was completely re-epithelialized in all rats. Squamous metaplasia was detected in 30% (3/10) of the 1 month group rats, and in 55% (6/11) of 4 month rats (P > 0.05). Gross calculi formation appeared in 20% (2/10) of the 1 month group rats, and in 34% (4/11) of 4 month rats (P > 0.05). Our data show that the use of the GSM flap in the bladder of a rat resulted in the complete re-epithelialization of the flap and sufficient bladder capacity. Despite significant complications such as death, metaplasia and calculi, this technique may be considered as an alternative experimental model to traditional full-thickness patching, which needs gastric or intestinal resection.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Epiplón
/
Colgajos Quirúrgicos
/
Vejiga Urinaria
/
Mucosa Gástrica
Tipo de estudio:
Diagnostic_studies
/
Etiology_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Animals
Idioma:
En
Revista:
Urol Res
Año:
2004
Tipo del documento:
Article