Kisanga R E, Aboud M M, Yongolo C M
Department of Surgery, Muhimbili University College of Health Sciences, Dar-es-Salaam, Tanzania.
Cent Afr J Med. 1996 Oct;42(10):288-90.
To determine the quality of life and complications in patients who underwent ureterosigmoidostomy for various indications.
Case series.
Urological clinic.
Nine patients who had good anal sphincter control and no upper urinary tract dilation, underwent urinary diversion via ureterosigmoidostomy by antireflux ureteral anastomosis. They were followed up for not less than five years.
Incidence of symptomatic urinary tract infections, metabolic derangement; occurrence of upper urinary tract dilation, frequency of emptying the rectum, incidence of soiling and quality of life.
The group as whole, experienced a total of 69 years of life with ureterosigmoidostomy diversion. There were no serious post operative complications. There were two incidences of urinary tract infection in the same patients who also had upper urinary tract dilation. Metabolic derangements and gross incontinence did not occur. All patients had satisfactory quality of life.
In under developed nations where patients cannot afford external appliances and the surgeon's skill for continent diversion is lacking, our results show that in properly motivated patients with a good functional anal sphincter and who are free of ureteral dilation, ureterosigmoidostomy can be a successful form of urinary diversion without the psychological and social burdens of a wet cutaneous stoma.
确定因各种适应症接受输尿管乙状结肠吻合术患者的生活质量和并发症情况。
病例系列研究。
泌尿外科诊所。
9例肛门括约肌控制良好且无上尿路扩张的患者，通过抗反流输尿管吻合术经输尿管乙状结肠吻合术进行尿流改道。对他们进行了不少于5年的随访。
有症状的尿路感染发生率、代谢紊乱情况；上尿路扩张的发生情况、直肠排空频率、粪便污染发生率及生活质量。
该组患者行输尿管乙状结肠吻合术改道后的总生存时间达69年。无严重术后并发症。同一例患者发生了2次尿路感染，该患者同时存在上尿路扩张。未发生代谢紊乱和严重失禁。所有患者的生活质量均令人满意。
在患者负担不起外部装置且外科医生缺乏可控性尿流改道技术的欠发达国家，我们的研究结果表明，对于有良好动机、肛门括约肌功能良好且无输尿管扩张的患者，输尿管乙状结肠吻合术可以成为一种成功的尿流改道方式，而不会带来皮肤造口潮湿的心理和社会负担。
