Stöckle M, Becht E, Voges G, Riedmiller H, Hohenfellner R
Department of Urology, Medical School, University of Mainz, Federal Republic of Germany.
J Urol. 1990 Apr;143(4):770-4; discussion 774-5. doi: 10.1016/s0022-5347(17)40089-9.
Long-term results among 46 children with ureterosigmoidostomy are presented. The indication for ureterosigmoidostomy had been bladder exstrophy in 40 patients, incontinent epispadias in 5 and neurogenic bladder dysfunction in 1. Of the 40 patients with bladder exstrophy 8 had undergone ureterosigmoidostomy after failure of other types of urinary tract reconstruction (6 had upper tract dilatation before ureterosigmoidostomy). Three patients with previously damaged upper urinary tracts required early postoperative conversion because of severely increasing kidney dilatation. Three other patients required conversion after a mean of 10 years to preserve kidney function. One patient died after 16 years of a cause not related to ureterosigmoidostomy. The remaining 39 patients were alive with a functioning ureterosigmoidostomy after a mean followup of 14.7 years. The daytime continence rate was 97.4% (38 of 39 patients) and the complete continence rate was 92.3% (36 of 39). Except for 1 tubular adenoma that was removed successfully during routine colonoscopy, no bowel neoplasia has been observed. None of the 45 living patients has renal insufficiency.
本文介绍了46例输尿管乙状结肠吻合术患儿的长期随访结果。40例输尿管乙状结肠吻合术的指征为膀胱外翻，5例为失禁性尿道上裂，1例为神经源性膀胱功能障碍。40例膀胱外翻患儿中，8例在其他类型尿路重建失败后接受了输尿管乙状结肠吻合术（6例在输尿管乙状结肠吻合术前存在上尿路扩张）。3例既往上尿路受损的患者因肾积水严重加重，术后早期需要进行改道。另外3例患者在平均10年后需要改道以保护肾功能。1例患者在16年后因与输尿管乙状结肠吻合术无关的原因死亡。其余39例患者在平均随访14.7年后存活，输尿管乙状结肠吻合术功能良好。白天控尿率为97.4%（39例患者中的38例），完全控尿率为92.3%（39例中的36例）。除1例在常规结肠镜检查时成功切除的管状腺瘤外，未观察到肠道肿瘤。45例存活患者均无肾功能不全。
