臨床に応用した人為膀胱の失敗例の教訓

Abstract

A female, aged 34, wife, suffered from serious irradiated inju r ies. Her pelvic viscerae had a severe damage which resulted in a vesicosigmoidal fistula. The authors did a total pelvic evisceration on the patient. Following the operation, the authors devised a modus to reconstruct an urinary tract. That is, the trigone was sutured with the peritoneum preperitoneally. The authors had expected that the remaining bladder will be developed to a perfect bladder due to the remarkable regenerative ability which is inheritted originally. Unfortunately, an urinary leakage occurred, then there was a giant dead space opening in the suprapubic region. The remaining bladder, the trigone, however, developed on the granulation of the dead space to an urinary collector. Now, the dead space itself is functioning as a kind of artificial bladder. This is the favorable result the authors did not expect, and the modus was named "Dead space vesicalization"- It might have a wide and fruitful development in future.