Zvara V, Slugen I, Breza J
Czech Med. 1986;9(3):117-23.
Two cases of colonic adenocarcinoma appearing 44 and 25 years, respectively, following an operation for urinary bladder exstrophy done according to Maydl are reported. A need for regular controls of patients with inner urine derivations has been emphasized. In the case of a suspected tumour it is necessary to alter the inner derivation to an outer one and also a resection of the colon at the site of the urinary bladder trigone is required. The Czech surgeon Karel Maydl was the first to implant the trigone of a splitted urinary bladder into the colon sigmoideum in 1892. This type of operation is used even today by several European urologists with excellent long-term results with respect to the preservation of an intact ureterovasical passage which prevents the reflux of the intestinal contents into the ureter, and also prevents the formation of strictures in the terminal parts of the ureter. In two patients who had been living for 25 and 44 years since they were operated on for urinary bladder exstrophy according to Maydl, a colonic adenocarcinoma was diagnosed. The tumour directly affected the implanted trigone wall and also involved the surrounding parts of the colon wall.
报告了两例分别在按照迈德尔方法进行膀胱外翻手术后44年和25年出现的结肠腺癌病例。强调了对采用体内尿液改道的患者进行定期检查的必要性。在怀疑有肿瘤的情况下,有必要将体内改道改为体外改道,并且还需要在膀胱三角区部位切除结肠。捷克外科医生卡雷尔·迈德尔于1892年首次将劈开的膀胱三角区植入乙状结肠。时至今日,几位欧洲泌尿科医生仍在使用这种手术方式,在保留完整的输尿管膀胱通道方面取得了出色的长期效果,该通道可防止肠内容物反流至输尿管,还可防止输尿管末端形成狭窄。在两名按照迈德尔方法进行膀胱外翻手术分别已存活25年和44年的患者中,诊断出了结肠腺癌。肿瘤直接侵犯了植入的膀胱三角区壁,还累及了结肠壁的周围部分。