術後10年で回腸導管に変更したコックパウチ造設例

Re-urinary diversion to ileal conduit after 10 years' Kock continent ileal reservoir：A case report

患者は71歳の女性で，61歳時膀胱腫瘍に対して膀胱全摘除術，コックパウチ造設術を受けていた。難治性のストーマ周囲皮下膿瘍と両側水腎症のために入院し，コックパウチ摘出と回腸導管造設術を行った。コックパウチのような禁制型尿路変向術には多くの晩期合併症がみられるため，今日ではその適応患者は限定される。

The patient was a 71-year-old woman who had been performed total cystectomy and Kock pouch construction for bladder cancer at her age of 61 years. She was admitted to our hospital because of obstinate parastomal subcutaneous abscess and bilateral hydronephrosis. She underwent excision of the Kock pouch and rediversion to an ileal conduit. Continent urinary diversion such as Kock pouch has many late complications,therefore recently its indication is limited in selected patient.