Martínez Salamanca Juan Ignacio, García Burgos Juan, Subirá Ríos David, Castaño González Irene, Moralejo Gárate Mercedes, Herranz Amo Felipe, de Palacio España Andres, Hernández Fernández Carlos
Servicio de Urología, Hospital General Universitario Gregorio Marañón, Madrid, España.
Arch Esp Urol. 2003 Jun;56(5):524-6.
To report complications that are very rare in patients undergoing radical cystectomy and Bricker's ileal conduit. In accordance to the literature and our own experience, to remark the importance of a proper preoperative preparation (nutritional, preanesthetic evaluation...), and adequate postoperative controls to avoid this kind of problems.
We report three cases which are demonstrative of these complications, their main characteristics, as well as their diagnosis, treatment, and outcomes.
All three cases were complicated by fistulae, with different outcomes. The diagnostic measures undertook on each one are reviewed in detail. Although it is well shown in the literature that most of these fistulae appear in patients with intestinal inflammatory/infectious diseases, this was not our experience.
After a bibliographic review and study of our cases, we insist on the importance of a good nutritional evaluation before surgery, and that radical cystectomy with Bricker's type urinary diversion, although consolidated as treatment for infiltrative bladder cancer, is not exempt of immediate postoperative complications or even deferred, as in our case.
报告根治性膀胱切除术及Bricker回肠膀胱术患者中极为罕见的并发症。根据文献及我们自身的经验，强调适当的术前准备（营养、麻醉前评估等）以及充分的术后检查对于避免此类问题的重要性。
我们报告三例可证明这些并发症及其主要特征、诊断、治疗和结果的病例。
所有三例均并发瘘管，结果各异。详细回顾了对每例患者采取的诊断措施。尽管文献充分表明这些瘘管大多出现在患有肠道炎性/感染性疾病的患者中，但我们的经验并非如此。
在进行文献综述并研究我们的病例后，我们坚持术前进行良好营养评估的重要性，并且根治性膀胱切除术加Bricker式尿流改道术，尽管已成为浸润性膀胱癌的治疗方法，但仍不免出现术后即刻并发症甚至延迟并发症，就像我们的病例一样。
