膀胱再建術の現況について : ColonBladderReplacernent

Abstract

1)男性膀胱癌22例に対し, 膀胱全摘出術後の膀胱再建術として, Colon Bladder Replacementを施行した.2)術後早期合併症は9例10件にみられ, うち1例で再手術が行われ, 結腸導管術に変更となった.多臓器不全による死亡が1例に認められた.3) 68.8%に完全尿禁制がえられ, 残りの症例の尿失禁・夜間遺尿の程度はいずれも軽度であった.4) Colon Bladder Replacementの膿尿陽性率は27.8%, 細菌尿陽性率は5.6%であった.5)膀胱癌患者における膀胱全摘出術後の膀胱再

Bladder replacement using a detubularized right colonic segment was successfully performed on 22 male patients with bladder cancer after radical cystectomy. There were 10 early postoperative complications and one of them required reoperation. Urodynamic studies, performed on 16 patients, showed a low pressure reservoir at a large capacity without any involuntary spikes in every case. Of the 16 patients, 4 were nocturnally enuretic and 1 was partially continent. The other 11 patients (68.8%) were totally continent and voiding well, except one who was on intermittent self-catheterization. The incidence of urinary reservoir infections in patients treated with colon bladder replacement was investigated in 18 patients. The incidence rate of bacteriuria was 5.6% and the positive rate of pyuria was 27.8%. The detection rate of bacteriuria and pyuria was significantly low in patients after colon bladder replacement. These findings indicate that colon bladder replacement can be an ideal option for selected patients with bladder cancer.