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PubMed1990

Nonrefluxing ileal ureteral replacement using the intussuscepted ileal nipple: laboratory studies.

A new technique for nonrefluxing ureteral replacement using ileum has been developed. Five adult mongrel dogs were operated using this nonrefluxing ileal ureteral technique. Subsequent reoperation showed in every case the preservation of renal function, a nonrefluxing system and no evidence of pyelonephritis or hydronephrosis. Based on the intussuscepted ileal nipple used in the Kock continent ileostomy, this technique has application in candidates for urinary undiversion, situations of ureteral loss due to trauma and fibrosis, and in patients with tuberculous strictured ureters.

Animals↗
PubMed1985

Urethral replacement using ileum with an intussuscepted ileal valve for continence.

Numerous techniques for replacing the urethra have been previously described, but attempts to provide continence have rarely been satisfactory. Urethral replacement using ileum with an ileal intussuscepted valve for continence has been successfully performed in ten female dogs. Eight of them were available for a 1 to 6-month followup. This neo-urethra has provided good continence and can be easily catheterized. The clinical usefulness of this technique in the treatment of total urethral loss in humans needs to be further explored.

Animals↗
PubMed1983

A case of ureteral intussusception associated with ureteral polyp.

We report a case of left ureteral intussusception associated with a ureteral polyp. At operation a 7 cm. long polyp was seen originating from the tip of the inside of the proximal ureter, causing 1.7 cm. of antegrade invagination. The polyp was resected and the invaginated region was repaired since pathological examination revealed a benign tumor. At followup an excretory urogram demonstrated prompt improvement of left hydronephrosis.

Female↗
PubMed2003

Rectosigmoidal bladder utilizing an intussuscepted ileal segment: a surgical technique for urinary diversion.

A novel technique of urinary diversion was designed by interposition of an intussuscepted ileal segment between the ureters and the rectosigmoidal pouch, thus preventing ureteral reflux as well as stenosis at the uretero-enteric anastomosis, possible occurrence of urocolonic carcinoma, and frequent evacuation or incontinence. Since all the procedures were limited to the lower abdominal cavity, the surgical invasiveness was compatible with that of an ileal conduit. Our early experience in 15 patients showed that this technique can be considered for those in whom the urethra is not available.

Adult↗
PubMed2006

Afferent intussuscepted antireflux nipple valve complications in the Kock pouch for continent urinary diversion Early results with a modified technique.

OBJECTIVES: To analyse the risk of afferent nipple valve stenosis and its consequences and management in patients with a Kock pouch for continent urinary diversion and to study the early results after using an alternative antireflux technique. MATERIAL AND METHODS: Sixty patients consecutively operated on with a conventional Kock reservoir for continent cutaneous urinary diversion between 1988 and 2001 were analysed with regard to the occurrence of afferent nipple valve stenosis and its clinical characteristics. Sixteen patients operated on for continent urinary diversion during the period 2002-04 had the antireflux valve constructed according to the serous-lined extramural ileal valve technique. RESULTS: Eight patients with a conventional Kock pouch developed true afferent nipple valve stenosis and the risk approached 30% after 15 years. Dilatation and stenting were usually successful. CONCLUSIONS: The high risk of afferent nipple valve stenosis when using the intussuscepted nipple valve in the construction of a Kock reservoir for continent cutaneous urinary diversion calls for an alternative method for anastomosing the ureters to the reservoir. Our early results with the combined Kock/T-pouch are promising.

Colonic Pouches↗
PubMedDate not supplied

Hydrostatic characteristics of the ileocolic valve and intussuscepted nipple valves: an animal model.

The ileocolic valve, in the dog, decelerates the passage of stools and prevents fecal reflux. A loss of anterograde resistance worsens the symptoms of short bowel syndrome. The absence of fecal reflux control enhances the risk of recurrence of Crohn's disease. The aim of the present study was to examine what length of intussusception-like nipple valve (INV) should be constructed in order to restore the hydrostatic characteristics of the normal ileocecal valve. The anterograde and retrograde hydrostatic resistances of INVs of different lengths (4, 5, 6, or 7 cm) were compared with those of the normal ileocolic valve by using a contrast enema and x-ray monitoring in a canine model. It was found that the 4-cm-long INV may be sufficient to achieve an appropriate antireflux efficacy (59.60 +/- 4.26 cm H(2)O) versus the ileocolic valve (25.80 +/- 4.92 cm H(2)O), but this does not furnish an anterograde resistance comparable to that of the normal ileocolic valve (10.70 +/- 1.15 cm H(2)O vs. 21.60 +/- 3.96 cm H(2)O). We found that the appropriate length of the INV with which the anterograde resistance of the ileocolic valve could be attained in our model was between 6 and 7 cm. Thus, the shortest possible constructed INV should be effective in clinical conditions such as Crohn's disease, but the recommended length in short bowel syndrome should be greater than this.

Animals↗
PubMed1976

Immunological and structural evidence for patterned intussusceptive surface growth in a unicellular organism. A postulated role for submembranous proteins and microtubules.

The surface complex of Euglena has been examined intact and after isolation and purification by the use of mild sonication to disrupt cells. In intact cells the surface complex (pellicle complex) is oriented in a series of parallel ridges and grooves, and possesses among other components a characteristic group of four to seven microtubules. Isolated pellicles retain the ridge and groove pattern but no microtubules are present. Isolates yielded at least three major polypeptides on SDS acrylamide gels; one or more of the polypeptides are postulated to be identical with a submembrane layer present in both intact and isolated pellicles; one polypeptide appears to be in or on the surface membrane. Antibodies directed against the isolated pellicles were conjugated directly or indirectly to fluorescein, latex spheres, or ferritin. In appropriate experiments with these antibody conjugates, it has been found that antigenic sites are immobile and that new antigenic sites (daughter strips) are inserted between parental strips in replicating cells. These results together with direct observation of daughter strips by transmission electron microscopy suggest that surface growth in Euglena occurs by intussusception. Microtubules associated with the pellicle complex are postulated to play a role in the development of new daughter strips, and possibly also in cell movements.

Antigens↗
PubMedDate not supplied

CT diagnosis of an unusual aortic dissection with intimointimal intussusception: the wind sock sign.

A unique combination of CT findings is reported in a rare case of aortic dissection with intimointimal intussusception. The CT showed a wind sock-like appearance in the contrast column of the aortic arch, which was felt to be characteristic of the intussuceptum. Complementary CT findings, including proximal flap in the dilated root of the aorta, no mid-ascending aortic flap, a descending aortic flap, and pericardial effusion, enabled establishment of the preoperative diagnosis.

Aortic Dissection↗
PubMed2003

Microsurgical vasoepididymostomy: a prospective randomized study of 3 intussusception techniques in rats.

PURPOSE: Vasoepididymostomy is a technically challenging but cost-effective treatment for obstructive azoospermia. We evaluated the outcomes of 3 intussusception vasoepididymostomy techniques, namely 3 suture triangulation, 2 suture transverse and a new 2 suture longitudinal technique. MATERIALS AND METHODS: Male Wistar rats were randomized into 4 experimental and 1 control groups. After 3 weeks of vasal obstruction bilateral vasoepididymostomy was performed. In group I, 3 sutures were placed in triangular fashion. In group II, 2 sutures were placed perpendicular to the tubule. In group III, 2 sutures were placed longitudinal to the tubule. The tubules were then opened in the direction of the needles and anastomosed to the vasa. After 5 months patency was evaluated in blinded fashion. RESULTS: The functional patency rate (presence of motile sperm in the vas) was 64%, 64% and 93% in groups I to III, respectively (p <0.001). As evaluated by methylene blue retrograde vasography toward the epididymis, the mechanical patency rate was similar for the 3 techniques, that is 86%, 86% and 93% in groups I to III, respectively. The sperm granuloma rate was significantly lower in group III (36%, 21% and 0% in groups I to III, respectively, p <0.001). CONCLUSIONS: Transverse 2 suture vasoepididymostomy has a patency rate similar to that of the 3 suture technique. Our new 2 suture longitudinal technique, which allows a larger opening in the epididymal tubule for anastomosis, is superior to the 2 and 3 suture techniques with respect to the patency and sperm granuloma rates.

Anastomosis, Surgical↗
PubMed2004

Rectosigmoidal bladder utilizing intussuscepted ileal segment: a surgical technique for urinary diversion and experiences in 30 patients.

BACKGROUND: We previously reported that the ileocecal rectal bladder consists of interposition of an intussuscepted ileocecal segment between the ureters and the rectum for those in whom the urethra is not available. Although the ileocecal rectal bladder has been well accepted by most patients, it requires an extensive preparation along the ascending colon. We present a modified operation technique (rectosigmoidal bladder) by using the ileal segment alone as an interposing antireflux component and by using the sigmoidal segment to augment the rectal capacity. METHODS: From February 1993 to July 2002, 30 patients with a median age of 64 years underwent construction of a rectosigmoidal bladder. Median follow-up period was 26 months (range, 13-125). The follow up was carried out using clinical and functional assessments such as evacuation status, serum chemistry and radiographic evaluation of the upper urinary tracts and rectosigmoidal pouch. To assess the postoperative health-related quality of life, we carried out a survey comparison of the ileocecal rectal bladder patients and the rectosigmoidal bladder patients. RESULTS: No operative or urinary diversion-related postoperative mortality was encountered. All rectosigmoidal bladders had sufficient capacity, with no evidence of urinary reflux or daytime incontinence. When compared with our previous procedure, the ileocecal rectal bladder, the present procedure had advantages with respect to complications with urine-fecal leak and acidosis. There were no differences in mean operation time, or in the health-related quality of life survey, between the two procedures. CONCLUSIONS: Our experience showed that this technique should be considered for those in whom the urethra is not available.

Adult↗
PubMed1996

Gastro-oesophageal intussusception in a young German shepherd dog.

A gastro-oesophageal intussusception in a female, six-week-old German shepherd dog was treated surgically with success. The dog was presented with acute dyspnoea and signs of shock. After laparotomy, the herniated organs were reduced from the lumen of the oesophagus into the abdomen and an imbrication of the oesophageal hiatus, an appositional fundoplication and a left-sided incisional fundopexy were performed. The dog made an uneventful recovery. Eighteen months after surgery the dog is still alive, with no clinical signs despite the persistent presence of megaoesophagus.

Animals↗
PubMed2003

Angiogenesis and vascular remodeling by intussusception: from form to function.

During most instances of angiogenesis, not only are the capillaries or terminal vessels generated and modified, but the supplying vascular system is subjected to remodeling as well. Intussusception, i.e., transluminal pillar formation, is one essential mechanism for growth, arborization, bifurcation remodeling, and pruning. Complex and efficient vascular beds can thus be generated by local interactions between vascular cells and hemodynamic conditions.

Animals↗
PubMed1976

Prevention of reflux by a ureteric intussusception valve: a preliminary study on dogs.

In 10 dogs in anti-reflux procedure by intussusception of the ureter is examined. The surgical procedure is developed and the urinary flow and prevention of the anti-reflux valve are explored. The study shows that an invagination is technically possible and that reflux can be prevented in half the cases without significant obstruction of the urinary flow.

Animals↗
PubMed1987

Inverted papilloma with intussusception of the ureter. Case report.

A case of inverted papilloma with intussusception of the ureter is reported. The patient is followed up 5 years after conservative treatment by partial resection of the ureter. No signs of urothelial tumor in the upper urinary tract or urinary bladder were revealed.

Adult↗
PubMed2000

Aortic dissection with intimal intussusception: diagnosis and management.

A man presented with acute chest and back pain with loss of consciousness. CT scan showed a mass in the arch that extended into the descending aorta. A diagnosis of type I aortic dissection was ultimately made by echocardiography. At surgery there was a circumferential intimal tear in the aortic root, and an intussuscepted dissection flap was retrieved from the arch and descending aorta.

Aortic Dissection↗
PubMed1992

[Why is intussusception an antireflux mechanism?].

One of the aims of bladder substitution or augmentation using the intestine is to preserve renal function. If reflux impairs renal function, an antireflux mechanism should be attempted. Direct ureteroileal reimplantation with spatulation of the ureter is safer and carries a lower risk of stenosis. The antireflux mechanism is created by ileoileal or ileocecal intussusception without involvement of the ureter. Thus we can diminish the risk of stenosis and reflux at the same time.

Humans↗
PubMed2004

[Vesicovaginal fistula which arose postoperatively after removal of the ureter by the intussusception method for renal pelvic tumor: a case report].

A 64-year-old woman underwent right nephroureterectomy of the ureter by the intussusception method under the diagnosis of right renal pelvic tumor in December 2001. Stress incontinence appeared postoperatively, and though conservative treatment was performed, it did not improve. The result of the pad-weighting test was 56 g indicating serious incontinence. In chain cystography, contrast media from the posterior wall of the urinary bladder to the vagina leaked out by the lateral view, and in cystoscopy, a fistula of about 2 mm in diameter was recognized in the right ureteral orifice trace. Under the diagnosis of vesicovaginal fistula, we performed transvaginal repair of the vesicovaginal fistula in November 2003. The urethral catheter was removed on the 14th postoperative day. After removal of the urethral catheter, urge incontinence was recognized, but it improved gradually. The recurrence of fistula and tumor has not been recognized at present.

Female↗
PubMed2005

Microvascular density, vascular endothelial growth factor immunoreactivity in tumor cells, vessel diameter and intussusceptive microvascular growth in primary melanoma.

Intussusceptive microvascular growth (IMG) corresponds to one of the types of angiogenesis described in literature. Recent morphological work strongly supports a role for IMG, even during tumor angiogenesis. In this study, the extent of angiogenesis, evaluated as microvascular density, the immunoreactivity of tumor cells to vascular endothelial growth factor (VEGF), the vessel diameter and the IMG have been correlated to the tumor thickness in human primary melanoma specimens. Results showed that an increased microvascular density, a strong VEGF immunoreactivity of tumor cells, a major vessel diameter and a high number of connections of intraluminal tissue folds with the opposite vascular wall, expression of IMG, are correlated to a high tumor thickness (>3.6 mm). Overall, these data demonstrate for the first time in human primary melanoma a relationship between angiogenesis, VEGF immunoreactivity of tumor cells, vessels diameter and IMG and seem to indicate that VEGF is specifically involved in increasing vessel diameter and IMG.

Adult↗