Roth S, Rathert P
Urologische Klinik, Krankenanstalten Düren, Akademisches Lehrkrankenhaus.
Urologe A. 1989 Jul;28(4):193-8.
The formation of a neobladder by the transformation of sections of the terminal ileum has become an important alternative to supravesical urinary diversion. The discussion about the optimal urosurgical technique however has, so far ignored the problems of consecutive enteric defunctionalization and deficiency symptoms resulting from the anatomical shortening of the ileum. The analysis of experimental investigations and functionally comparable syndromes, such as Crohn's disease, permits an insight into the pathophysiological consequences. These relate to disorders in the bile acid and vitamin B12 metabolism and to the potential induction of a secondary hyperoxaluria, with a subsequent oxalate calculus diathesis. Further more, the reduction of the absorption area in the ileum can lead to calcium and vitamin D malabsorption with the development of intestinal osteopathy. These pathophysiological relationships must be taken into account in the long-term medical care of patients with ileal neobladder. The preventive and therapeutic measures are described.
通过回肠末端部分的改造形成新膀胱已成为膀胱上尿路改道的一种重要替代方法。然而，关于最佳泌尿外科手术技术的讨论至今忽略了连续肠道去功能化问题以及因回肠解剖学缩短导致的缺乏症状。对实验研究以及功能类似综合征（如克罗恩病）的分析有助于深入了解病理生理后果。这些后果涉及胆汁酸和维生素B12代谢紊乱以及继发性高草酸尿症的潜在诱导，随后引发草酸盐结石素质。此外，回肠吸收面积的减少可导致钙和维生素D吸收不良，并伴有肠道骨病的发展。在回肠新膀胱患者的长期医疗护理中必须考虑这些病理生理关系。文中描述了预防和治疗措施。
