Yamamoto A, Kanayama H, Naruo S, Takigawa H, Kagawa S
Department of Urology, School of Medicine, University of Tokushima, Japan.
Eur Urol. 1995;27(3):236-40. doi: 10.1159/000475168.
Between November 1989 and June 1993, 41 patients (78 renal units) underwent Camey-Le Duc technique for prevention of reflux of a Kock pouch. In 30 patients the ileal reservoir was connected to the skin for cutaneous urinary diversion, and in 11 it was connected to the urethra for lower urinary reconstruction. The mean postoperative follow-up period was 23 months, with a range of 6-47 months. Postoperative excretory urography (IVP) was performed at least once a year to evaluate the upper urinary tract configuration, and ascending cystography was performed to evaluate the reflux. No urinary tract dilatation was observed in 73 renal units (93.6%), while slight dilatation was noted in 3 (3.8%), moderate dilatation in 1 (1.3%), and marked dilatation in 1 (1.3%). Reflux was not found in any patient. Of 23 renal units in 12 patients in whom the last IVP examination was performed 6 months postoperatively, dilatation was noted in 4 (17.4%). In contrast, of 55 renal units in 29 patients in whom the last IVP examination was performed 12 months or more after the Kock pouch operation, dilatation was noted in only 1 (1.8%). We conclude that the Camey-Le Duc antireflux technique is effective in terms of simplicity and reliability.
1989年11月至1993年6月期间，41例患者（78个肾单位）接受了Camey-Le Duc技术以预防Kock贮尿囊反流。30例患者的回肠贮尿囊与皮肤相连用于皮肤造口尿液转流，11例患者的回肠贮尿囊与尿道相连用于下尿路重建。术后平均随访期为23个月，范围为6至47个月。每年至少进行一次术后排泄性尿路造影（IVP）以评估上尿路形态，并进行上行性膀胱造影以评估反流情况。73个肾单位（93.6%）未观察到尿路扩张，3个（3.8%）有轻度扩张，1个（1.3%）有中度扩张，1个（1.3%）有重度扩张。未发现任何患者有反流。在术后6个月进行最后一次IVP检查的12例患者的23个肾单位中，4个（17.4%）有扩张。相比之下，在Kock贮尿囊手术后12个月或更长时间进行最后一次IVP检查的29例患者的55个肾单位中，只有1个（1.8%）有扩张。我们得出结论，Camey-Le Duc抗反流技术在操作简便性和可靠性方面是有效的。
