失禁型尿路変更術

Abstract

1)膀胱癌に対する膀胱全摘除術時に尿路変更として, 回腸導管を188例に, 尿管瘻を49例に行った.2)術後30日以内の死亡はなかった.3)術後の早期合併症は, 回腸導管94, 尿管瘻18, 晩期合併症は, 回腸導管85, 尿管瘻23に認められた.合併症を認めなかったのは, 回腸導管49, 尿管瘻14であった.4)回腸導管の術後早期合併症は, 創感染(29%), 消化管疾患(13%), 上部尿路疾患(12%)が多くみられ, 晩期合併症は, ストーマの異常(26%), 上部尿路疾患(14%), 肝炎(13%)が多くみられた.5)回腸導管は

We analyzed 237 patients who underwent total cystectomy with ileal conduit urinary diversion or cutaneous ureterostomy at the Center for Adult Diseases, Osaka. One-hundred and eighty-eight patients underwent ileal conduit diversion and 49 patients underwent cutaneous ureterostomy. No patient died within 30 days after the operation, but two patients who underwent ileal conduit diversion died of postoperative complications within 2 months. Early complications occurred in 94 patients (50%) in the ileal conduit group and in 18 patients (37%) in the ureterostomy group. Late complications occurred in 85 patients (45%) in the ileal conduit group and in 23 patients (47%) in the ureterostomy group. Frequent early complications in the ileal conduit group were wound infection (29%), and intestinal complications (13%) which included ileus and upper urinary tract complications (12%). The most frequent late complications were stomal complications (26%) which included peristomal dermatitis stomal stenosis, parastomal hernia, and stomal prolapse, and upper urinary tract complications which were noted in 27 patients (14%).