Yokota Narushi, Ito Fumio, Ishikawa Tetsuo, Yamashita Kaori, Nakazawa Hayakazu
Department of Urology, Tokyo Women's Medical University Medical Center East.
Nihon Hinyokika Gakkai Zasshi. 2013 Jul;104(4):616-9. doi: 10.5980/jpnjurol.104.616.
We report a case of neobladder-rectal fistula that developed as an early postoperative complication of radical cystectomy and orthotopic neobladder construction procedures. A 75-year-old man underwent a radical cystectomy and orthotopic neobladder construction using Studer's method for locally invasive bladder cancer (cT2N0M0). The patient had severe watery diarrhea on postoperative day 20, and was diagnosed with a neobladder-rectal fistula based on cystography findings. We inserted a Foley catheter into the neobladder, and performed conservative treatment. Four months after development of the fistula, cystography revealed that it had spontaneously closed. A neobladder-rectal fistula is an extremely rare complication, with no other known reports. Herein, we present this case of neobladder-rectal fistula and discuss its formation, diagnosis and treatment, along with reference to previous reports of neobladder-vaginal fistulas.
我们报告一例新膀胱直肠瘘病例，该病例是根治性膀胱切除术和原位新膀胱构建术后早期出现的并发症。一名75岁男性因局部浸润性膀胱癌（cT2N0M0）接受了根治性膀胱切除术，并采用施图德（Studer）方法进行原位新膀胱构建。患者在术后第20天出现严重水样腹泻，根据膀胱造影结果诊断为新膀胱直肠瘘。我们在新膀胱内插入了一根福勒氏导尿管，并进行了保守治疗。瘘管形成四个月后，膀胱造影显示瘘管已自行闭合。新膀胱直肠瘘是一种极其罕见的并发症，尚无其他相关报道。在此，我们呈现这例新膀胱直肠瘘病例，并结合既往新膀胱阴道瘘的报道，对其形成、诊断和治疗进行讨论。
