Stein Raimund, Zahn Katrin, Huck Nina
Department of Pediatric, Adolescent and Reconstructive Urology, Medical Faculty Mannheim, Medical Center Mannheim, Heidelberg University, Mannheim, Germany.
Front Pediatr. 2019 Jun 12;7:236. doi: 10.3389/fped.2019.00236. eCollection 2019.
Today, there are few indications for the use of bowel in pediatric urology. This is in large extent due to the successful conservative therapy in patients with neurogenic bladder and the improved success of primary reconstruction in patients with the bladder exstrophy-epispadias complex. Only after the failure of the maximum of conservative therapy or after failure of primary reconstruction, bladder augmentation, or urinary diversion should be considered. Malignant tumors of the lower urinary tract (e.g., rhabdomyosarcomas of the bladder/prostate) are other rare indications for urinary diversion. Replacement or reconstruction of the ureter with a bowel segment is also a quite rarely performed procedure. In this review, the advantages and disadvantages of the different options for the use of bowel segments for bladder augmentation, bladder substitution, urinary diversion, or ureter replacement during childhood and adolescence are discussed.
如今，小儿泌尿外科中肠道的使用指征已很少见。这在很大程度上归因于神经源性膀胱患者保守治疗的成功以及膀胱外翻-尿道上裂综合征患者一期重建成功率的提高。只有在最大程度的保守治疗失败后或一期重建失败后，才应考虑膀胱扩大术或尿流改道术。下尿路恶性肿瘤（如膀胱/前列腺横纹肌肉瘤）是尿流改道的其他罕见指征。用肠段替代或重建输尿管也是一种很少进行的手术。在本综述中，讨论了儿童和青少年时期使用肠段进行膀胱扩大术、膀胱替代术、尿流改道术或输尿管替代术的不同选择的优缺点。
