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Title: Kock pouchのnipple valve固定状態についての内視鏡的検討
Other Titles: Endoscopic findings of nipple fixation in Kock pouch
Authors: 山本, 晶弘  KAKEN_name
滝川, 浩  KAKEN_name
上間, 健造  KAKEN_name
浜尾, 巧  KAKEN_name
香川, 征  KAKEN_name
黒川, 泰史  KAKEN_name
山本, 修三  KAKEN_name
炭谷, 晴雄  KAKEN_name
Author's alias: Yamamoto, Akihiro
Takigawa, Hiroshi
Uema, Kenzo
Hamao, Takumi
Kagawa, Susumu
Kurokawa, Yasushi
Yamamoto, Shuzo
Sumitani, Haruo
Keywords: Kock pouch
Nipple valve fixation
Issue Date: Mar-1992
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 38
Issue: 3
Start page: 281
End page: 284
Abstract: 1987年3月より1990年12月までにKock pouch造設術を施行した34例のうち28例において,pouch内視鏡を施行し,nipple valveの固定状態を観察,より確実な固定方法について検討した.1)輸出脚nipple valveの固定状態は,粘膜下同士の固定を施行した17例では,poor 3例,free 5例と固定不良の症例がかなりみられたのに対し,全層固定した9例では,good 5例,moderate 4例と固定状態は良好であった.また自動縫合器による固定を行った2例はいずれもgoodであった.2)輸入脚nipple valveの固定状態は,粘膜下同士の固定を行った17例ではpoor 6例,free 2例と,輸出脚と同様に,固定不良の症例が多くみられた.全層固定および自動縫合器による固定を行った症例はそれぞれ2例ずつで,いずれもgood, moderateが1例ずつであった.3)全層固定を行った9例のうち1例でprolapseがみられた.4)全層固定は確実性が高く,nipple valve合併症の予防のために有効と考えられた
Fixing the nipple to the pouch wall is indispensable to reduce the incidence of late complications of the Kock pouch. We performed endoscopy of the Kock pouch in 28 patients to evaluate the nipple valve fixation. We carried out submucosal fixation of nipple in 17 patients, fixation using staples in 2 patients and full layer fixation in last 9 patients. On endoscopy, both efferent and afferent nipples were poorly fixed or completely detached in 8 of the 17 patients who underwent submucosal fixation. On the other hand, there were no patients in whom the nipple was poorly fixed or completely detached among the other 11 patients. We experienced nipple malfunction in only one of the last 9 patients. Based on endoscopic findings and clinical results, we concluded that full layer fixation was reliable and useful to reduce the incidence of nipple valve complications.
PubMed ID: 1523982
Appears in Collections:Vol.38 No.3

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