回盲部導管による尿路変向術

Abstract

We have performed ileocecal conduit for urinary diversion to prevent stomal stenosis and ileoureteral reflux since 1975. Forty four cases of ileocecal conduit were studied and compared with thirty cases of ileal conduit. Postoperative pyelogram showed satisfactory result and the frequency of postoperative complication was about the same as that of ileal conduit. We experienced more cases of ileus as a late omplication especially in the cases those had postoperative irradiation. We concluded postoperative irradiation promoted the occurrence of ileus. Two patients of ileocecal conduit and one patient of ileal conduit developed renal stone. Though the genesis of urolithiasis is not clear, it is possible to prevent residual urine and ileoureteral reflux in the patients of ileocecal conduit in view of the results of pressure studies and conduitography. There is no difficulty in the operative procedure such as isolating ileocecal segment or anastmosis of the intestine. We consider ileocecal conduit as a satisfactory method for urinary diversion, but to date there are no reports about the long-term result of a large numbers of cases of ileocecal conduit. We think this procedure will be more adequately evaluated on accumulation of many cases.