Ahlering T E, Weinberg A C, Razor B
Department of Urology, University of Southern California School of Medicine.
Acta Urol Belg. 1991;59(2):303-13.
Between July 1986 and July 1988, 55 urinary diversion procedures were performed: 18 ileal conduits, 12 Kock pouches and 25 Indiana pouches. The different forms of urinary diversion were compared for patient selection, operative technical demands, postoperative complications, perioperative renal function, and short-term followup including re-hospitalizations, revisions, and pouch function. Patient selection was the same for the ileal conduit and Indiana pouch patients. Kock pouch patients were more highly selected for youth and health status. The operative technical demands of the ileal conduit and Indiana pouch were similar. The average operative time and blood loss for cystectomy and ileal conduit was 5:27 hours and 1290 cc's versus 5:30 hours and 1201 cc's for the Indiana pouch group. Postoperative complications and changes in renal function were similar among all three groups except for an increase in urinary anastomotic leaks in heavily irradiated ileal conduit patients. The ileal conduit patients required no re-hospitalizations or revisions; the Indiana pouch group had four re-hospitalizations and no revisions; the Kock pouch group had nine re-hospitalizations and three revisions. The day and night-time continence rate was 100% in both the Indiana and Kock pouch groups. The Indiana pouch has similar technical demands as the ileal conduit, has similar postoperative complications as the ileal conduit or Kock pouch, and functions well with a low revision rate. We conclude that the modified Indiana pouch can be just as safely and effectively accomplished in any patient requiring an ileal conduit.
1986年7月至1988年7月期间，共进行了55例尿流改道术：18例回肠膀胱术、12例考克贮尿囊术和25例印第安纳贮尿囊术。对不同形式的尿流改道术在患者选择、手术技术要求、术后并发症、围手术期肾功能以及包括再次住院、修复手术和贮尿囊功能在内的短期随访方面进行了比较。回肠膀胱术和印第安纳贮尿囊术患者的选择标准相同。考克贮尿囊术患者在年龄和健康状况方面的选择更为严格。回肠膀胱术和印第安纳贮尿囊术的手术技术要求相似。膀胱切除术加回肠膀胱术的平均手术时间和失血量分别为5小时27分钟和1290毫升，而印第安纳贮尿囊术组为5小时30分钟和1201毫升。除了接受大量放疗的回肠膀胱术患者尿路吻合口漏增加外，三组术后并发症和肾功能变化相似。回肠膀胱术患者无需再次住院或进行修复手术；印第安纳贮尿囊术组有4例再次住院，无修复手术；考克贮尿囊术组有9例再次住院，3例修复手术。印第安纳贮尿囊术组和考克贮尿囊术组的日间和夜间控尿率均为100%。印第安纳贮尿囊术与回肠膀胱术的技术要求相似，与回肠膀胱术或考克贮尿囊术的术后并发症相似，且功能良好，修复率低。我们得出结论，对于任何需要行回肠膀胱术的患者，改良印第安纳贮尿囊术都能同样安全有效地完成。
