L'impianto antireflusso nelle derivazioni urinarie ortotopiche ed esterne continenti (DUEC). Nostra esperienza

An assessment is made of the morpho-functional results of ureterointestinal anastomoses with antireflux technique in 84 patients subjected to radical cystectomy with orthotopic urinary diversion according to Camey II or continent external urinary diversion (DUEC). The anastomosis techniques were: in 37 patients the nipple according to Ricard, in 35 the nipple modified with our variant (exeresis of a circular section instead of the enterotomy in the implantation seat) and in 12 the SLE tunnel according to Abol-Enein and Ghoneim. Stenosis occurred in 8% of cases and reflux in 4.4% with the original nipple technique; with the variant to enterotomy in 4.1% and 2.9% respectively; there were no complications with the SLE tunnel technique with Camey II construction. It is concluded that in the presence of dilated and atonic ureters, the SLE tunnel technique applied to the diversion according to Camey II gives particularly convincing results, while the direct ureteral implant is only indicated in normotonic and normoperistaltic ureters.