Meyrat B J, Berger D, Stucky P
Department of Pediatric Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Eur J Pediatr Surg. 1991 Jun;1(3):172-6. doi: 10.1055/s-2008-1042481.
We reviewed 15 patients who underwent 16 ureterosigmoidostomies from 1975 to 1989. The underlying disease was bladder exstrophy in 13 patients. Urinary diversions have been performed according to Mathisen in 15 patients, one reoperation has been performed according to Coffey. Standard post-operative controls consist of physical examinations, capillary blood gas samples, intravenous pyelograms, inulin clearance measurements, 123I-hippuran scintigraphies and colonoscopies. Results concerning continence are judged very satisfactory in 80% of patients. 34% of patients presented with one or more episodes of unilateral or bilateral pyelonephritis. Intravenous pyelograms showed improved or unchanged urinary tract dilatation in 45% of kidneys and moderate and severe dilatation in 55%. Inulin clearance remained in normal range in 4 out of 6 patients followed. Renal function assessed by means of renal scintigraphy remained unchanged in 61% of kidneys, slightly decreased in 22% and severely in 17%. All patients are kept on a sodium-citrate therapy. Only one patient shows growth disturbances. Out of 9 patients followed with colonoscopy, none showed signs of malignancy.
我们回顾了1975年至1989年间接受16例输尿管乙状结肠吻合术的15例患者。13例患者的基础疾病为膀胱外翻。15例患者根据马蒂森方法进行了尿流改道，1例根据科菲方法进行了再次手术。标准的术后检查包括体格检查、毛细血管血气样本、静脉肾盂造影、菊粉清除率测量、123I-马尿酸盐闪烁扫描和结肠镜检查。80%的患者尿失禁结果被判定为非常满意。34%的患者出现一次或多次单侧或双侧肾盂肾炎发作。静脉肾盂造影显示45%的肾脏尿路扩张改善或不变，55%的肾脏有中度和重度扩张。6例接受随访的患者中有4例菊粉清除率保持在正常范围内。通过肾闪烁扫描评估的肾功能在61%的肾脏中保持不变，22%的肾脏略有下降，17%的肾脏严重下降。所有患者均接受柠檬酸钠治疗。只有1例患者出现生长发育障碍。在9例接受结肠镜检查随访的患者中，无1例显示恶性肿瘤迹象。
