Schmidt J D, Buchsbaum H J, Nachtsheim D A
Br J Urol. 1985 Jun;57(3):284-8. doi: 10.1111/j.1464-410x.1985.tb06345.x.
In the past 6 years, an additional 22 patients with extensive pelvic irradiation have had their upper urinary tracts diverted employing the transverse colon conduit. Most procedures were performed with radical cystectomy following high dose radiotherapy in patients with bladder cancer or with pelvic exenteration for recurrent cervical cancer. The operative mortality rate was unchanged at 4%. Upper urinary tracts and renal function have remained stable or improved in 88 and 95% of patients respectively. Although most conduits were constructed with refluxing ureterocolic anastomoses and without stents, the more recent procedures have employed both antireflux submucosal tunnel anastomoses and stents. Nineteen of 25 patients diverted by this method between 1970 and 1976 have been followed for up to 155 months. All patients with recurrent or persistent malignancy have died (mean survival 44 months). Seven patients (37%) are living and well (mean survival 104 months). Upper urinary tracts remain normal in two-thirds of those with the longer follow-up. Major complications requiring additional surgery continue to occur in one-third of this highly selected group of patients in whom the transverse colon conduit remains the preferred diversionary technique.
在过去6年中，另外22例接受广泛盆腔照射的患者采用横结肠导管进行了上尿路改道。大多数手术是在膀胱癌患者接受高剂量放疗后行根治性膀胱切除术，或对复发性宫颈癌患者行盆腔脏器清除术时进行的。手术死亡率维持在4%不变。分别有88%和95%的患者上尿路和肾功能保持稳定或有所改善。尽管大多数导管采用反流性输尿管结肠吻合术且未放置支架，但最近的手术同时采用了抗反流黏膜下隧道吻合术和支架。1970年至1976年间采用这种方法改道的25例患者中有19例接受了长达155个月的随访。所有复发或持续存在恶性肿瘤的患者均已死亡（平均生存期44个月）。7例患者（37%）存活且状况良好（平均生存期104个月）。在随访时间较长的患者中，三分之二的患者上尿路仍保持正常。在这一经过严格挑选、横结肠导管仍是首选改道技术的患者群体中，仍有三分之一的患者出现需要再次手术的主要并发症。
