Benchekroun A, Lachkar A, Soumana A, Farih M H, Belahnech Z, Marzouk M, Faik M
Clinique Urologique A, CHU Ibn Sina, Rabat, Maroc.
Ann Urol (Paris). 1998;32(2):95-8.
35 patients underwent ureterosigmoidostomy between 1986 and 1996, corresponding to 25 males (71%) and 10 females (29%) with a mean age of 48 years (range: 21 to 81 years). 25 (71%) of these patients had invasive bladder cancer, 4 (12%) had a vesicovaginal fistula, 3 (9%) had bladder exstrophy and 3 (9%) had urethral trauma. All patients had normal renal function. In 2 patients, the ureter was dilated and in 3 other patients, one kidney was silent. The postoperative course are marked by death in 2 cases (6%) due to myocardial infarction, mechanical obstruction in 2 cases (6%), anastomotic dehiscence in 2 cases (6%). The mean follow-up was 4 years (range: 2 to 10 years). Eight patients (22%) developed impaired renal function, isolated hyperchloraemic acidosis was observed in 10 cases (28%), hypokalaemia was observed in 2 cases (6%), and episodes of acute pyelonephritis were reported in 4 cases (11%). Radiological signs of upper urinary tract deterioration were observed in 6 cases (17%). A tumour of the sigmoid colon was observed in one case after a follow-up of 10 years. 25 patients (72%) remain dry throughout the night, while 8 (22%) need to empty their rectum during the night. The poorly tolerated Coffey diversion was replaced in 6 patients (17%). The objective of this study is to analyse the results of ureterosigmoidostomy and to emphasize the advantages and disadvantages of this urinary diversion technique.
1986年至1996年间，35例患者接受了输尿管乙状结肠吻合术，其中男性25例（71%），女性10例（29%），平均年龄48岁（范围：21至81岁）。这些患者中，25例（71%）患有浸润性膀胱癌，4例（12%）患有膀胱阴道瘘，3例（9%）患有膀胱外翻，3例（9%）患有尿道创伤。所有患者肾功能均正常。2例患者输尿管扩张，另外3例患者一侧肾脏无功能。术后病程中，2例（6%）因心肌梗死死亡，2例（6%）出现机械性梗阻，2例（6%）出现吻合口裂开。平均随访时间为4年（范围：2至10年）。8例患者（22%）出现肾功能损害，10例（28%）观察到单纯性高氯性酸中毒，2例（6%）观察到低钾血症，4例（11%）报告有急性肾盂肾炎发作。6例（17%）观察到上尿路恶化的影像学征象。随访10年后，1例患者发现乙状结肠癌。25例患者（72%）夜间保持干爽，而8例（22%）需要在夜间排空直肠。6例患者（17%）更换了耐受性差的科菲改道术。本研究的目的是分析输尿管乙状结肠吻合术的结果，并强调这种尿流改道技术的优缺点。
