骨盤部放射線照射後症例に対する尿路変向術: 横行結腸導管再訪

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タイトル別名
  • Urinary Diversion in Patients Treated with Pelvic Irradiation : Transverse Colon Conduit Revisited
  • コツバンブ ホウシャセン ショウシャ ゴ ショウレイ ニ タイスル ニョウロ ヘンコウジュツ : オウコウ ケッチョウ ドウカン サイホウ

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In patients receiving pelvic irradiation for gynecological or genitourinary malignancies, urinary diversion is sometimes required for complete resection of malignancies or treatment of urological complications by irradiation. We report our attempts to promote healing and prevent complications by urinary diversion using a transverse colon conduit in cases in which urinary reconstruction was performed with irradiated lower abdominal organs such as small intestine or distal ureters. Between 2008 and 2012, 9 patients with pelvic irradiation received transverse colon conduit urinary diversion. Six patients received diversion for genitourinary complications, while 3 patients received complete resection of pelvic malignancies. Colostomy formation and lithotripsy of vesical stones were simultaneously performed in 4 cases. Wallace method was adopted for ureterointestinal anastomosis. There was no operative mortality. Although acute pyelonephritis, ileus, wound dehiscence and pelvic abscess formation were seen as postoperative complications, all but two improved without any additional procedure. Cases of pelvic abscess or wound dehiscence were treated by abscess drainage. In observation periods, no patients required urinary stent placement and none suffered from defecation problems. We think that transverse colon conduit can be a viable option for patients with pelvic irradiation history, affording them reasonable quality of life postoperatively.

収録刊行物

  • 泌尿器科紀要

    泌尿器科紀要 60 (8), 365-370, 2014-08

    泌尿器科紀要刊行会

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