Bissada N K, Morcos R R, Morgan W M, Hanash K A
Medical University of South Carolina, Charleston, USA.
J Urol. 1995 May;153(5):1429-31. doi: 10.1016/s0022-5347(01)67420-2.
Between January 1977 and June 1985, 63 patients requiring supravesical diversion underwent ureterosigmoidostomy with an antireflux technique. Of the patients 49 had bladder cancer and 14 had other conditions. Two patients died in the postoperative period. Postoperatively, all patients were instructed to empty the rectum frequently, and received bicarbonate and potassium supplementation. Median followup was 41 months (range 3 to 70). Renal function remained stable in 92% of the patients. Radiographic deterioration occurred in 23% of the renal units, which was severe in 7%. These results indicate that the short and intermediate followup results with ureterosigmoidostomy are comparable to those of an ileal conduit. The method has the added advantage of being a form of continent diversion. We believe that ureterosigmoidostomy remains a viable and convenient alternative in select patients with bladder cancer who are not suitable for other forms of continent diversion or bladder substitution.
1977年1月至1985年6月期间，63例需要膀胱上改道的患者接受了采用抗反流技术的输尿管乙状结肠吻合术。其中49例患者患有膀胱癌，14例患有其他疾病。2例患者在术后死亡。术后，所有患者均被指导要经常排空直肠，并接受碳酸氢盐和钾补充剂。中位随访时间为41个月（范围3至70个月）。92%的患者肾功能保持稳定。23%的肾单位出现影像学恶化，其中7%为严重恶化。这些结果表明，输尿管乙状结肠吻合术的短期和中期随访结果与回肠代膀胱术相当。该方法还有一个额外的优点，即它是一种可控性改道形式。我们认为，对于某些不适合其他形式可控性改道或膀胱替代的膀胱癌患者，输尿管乙状结肠吻合术仍然是一种可行且方便的选择。
