Rickham P P, Stauffer U G
Prog Pediatr Surg. 1984;17:169-88.
The different methods of treatment of bladder exstrophy are described. Ureterosigmoidostomy and its various modifications are discussed and the longterm result critically reviewed. Urinary diversion by transplanting the ureters into an isolated segment of ileum or colon should, in the authors' opinion, only very rarely be necessary. Cutaneous ureterostomy is used only as a last resort in incontinent patients with severe renal damage. The greatest single advance in the management of the malformation has been the two-stage closure of the exstrophic bladder. The authors' experiences in the two-stage closure of 28 patients with ectopia vesicae are described. No selection of patients was practiced. The results obtained, both clinically and by manometry of the operated bladder, are reviewed. The results are moderately satisfactory.
本文描述了膀胱外翻的不同治疗方法。讨论了输尿管乙状结肠吻合术及其各种改良术式，并对其长期效果进行了批判性回顾。作者认为，将输尿管移植到一段孤立的回肠或结肠中进行尿流改道的情况应该非常罕见。皮肤输尿管造口术仅在患有严重肾损害的尿失禁患者中作为最后手段使用。在畸形治疗方面最大的单项进展是膀胱外翻的两期闭合。描述了作者对28例膀胱外翻患者进行两期闭合的经验。未对患者进行选择。回顾了手术膀胱的临床及测压结果。结果中度令人满意。
