虫垂を利用した尿路変更術の2例

Abstract

We report two cases of urinary diversion through an appendix. Case 1. An 81-year-old man was hospitalized with oliguria. The patient had a past history of left nephro-ureterectomy for left ureteral tumor. Ultrasound showed right hydronephrosis due to recurrence in the bladder and right ureter. A total cystectomy and partial ureterectomy were carried out, and an appendix conduit was constructed because the ureter was not sufficiently long for ureterocutaneostomy. Case 2. A 68-year-old woman with diabetic neurogenic bladder, hypothyroidism, and chronic obstructive lung disease was hospitalized with the complaint of difficulty in self-catheterization. Continent vesicostomy was carried out according to the method of Mitrofanoff using the appendix. Both patients were tubeless and without postoperative complications before discharge. Appendix conduit and Mitrofanoff operation, which can be performed by a simple surgical procedure, are considered to be applicable to poor risk cases.