Kato T, Sato K, Kakinuma H, Kobayashi M, Tamura K
Department of Urology, Akita University School of Medicine, Japan.
Int J Urol. 1994 Jun;1(2):156-61. doi: 10.1111/j.1442-2042.1994.tb00026.x.
Technetium 99m diethylenetriaminepentaacetic acid renoscintigraphy was applied to 14 patients to obtain comprehensive information on the kidney and urinary tract 12.6 +/- 8.8 months (mean +/- SD) after uretero-ileoceco-proctostomy (ileocecal rectal bladder) diversion. The total glomerular filtration rate (GFR) was within the normal range in all patients, and the diuretic renogram was normal in 19 of 28 kidneys, dilated-nonobstructive in 7 and obstructive-intermediate in 2. The mean colonic reflux was 16.6 +/- 18.4% of total excretion and the mean total residual in the colon and rectum was 38.8 +/- 15.5%. In the second study, performed 12.4 +/- 3.5 months later in 9 patients, the GFR of bilateral and individual kidneys remained stable, 17 of 18 kidneys were normal as judged by both renography and pyelography, and the occurrence and degree of colonic reflux decreased. There was a tendency for the rectal capacity to increase, while the total residual tended to decrease solely due to the decrease in colonic residual. These results indicate that the ileocecal rectal bladder functions well as an internal continent reservoir and that radionuclide investigation is a valuable and cost-beneficial means of follow-up of urinary diversions.
在输尿管-回盲肠-直肠造口术（回盲肠直肠膀胱）改道术后12.6±8.8个月（平均±标准差），对14例患者进行了锝99m二乙三胺五乙酸肾闪烁显像，以获取有关肾脏和尿路的全面信息。所有患者的总肾小球滤过率（GFR）均在正常范围内，28个肾脏中有19个的利尿肾图正常，7个为扩张性无梗阻，2个为梗阻性中度。结肠反流的平均值占总排泄量的16.6±18.4%，结肠和直肠的平均总残余量为38.8±15.5%。在第二项研究中，9例患者在12.4±3.5个月后进行，双侧和单个肾脏的GFR保持稳定，18个肾脏中有17个经肾图和肾盂造影判断正常，结肠反流的发生率和程度降低。直肠容量有增加的趋势，而总残余量仅因结肠残余量的减少而趋于减少。这些结果表明，回盲肠直肠膀胱作为一种可控性内储尿囊功能良好，放射性核素检查是尿流改道随访的一种有价值且成本效益高的手段。
