腸管利用の尿管・膀胱形成術の13例

ENTEROCYSTOPLASTY AND ENTEROURETEROPLASTY : 13 CASES

　尿管狭窄または萎縮膀胱の13例に14回腸管を利用した尿管形成あるいは膀胱拡大術を施行した。遠隔成績（中央値4年6月）では，腎機能上問題を生じた症例は2例で，うち1例は遊離腸管のぜん動運動亢進による尿失禁と腎機能低下のため再手術を行ない，他の1例は逆流による水腎の進行のため横行結腸導管へ変更した。残る症例は年数回の急性腎盂炎を生じたものが3例あったが，腎機能上の問題はなく，日常生活にもほぼ支障がなかった。

Thirteen patients with ureteral stricture or a contracted bladder who underwent uretero-or cysto-plasty using the intestine were reviewed. The median follow-up period was 4 years and 6 months. One patient developed impaired renal function and persistent urinary incontinence owing to hyperperistalsis of the isolated intestine and underwent reoperation. Another patient developed progressive hydronephrosis secon-dary to reflux and underwent urinary diversion. The remaining patients, although acute pyelonephritis developed several times a year in three patients, had almost no trouble in daily life with favorable renal function.