回腸による導尿路作成と膀胱拡大術を行った先天性神経因性膀胱の2例

Urinary tract reconstruction using ileovesicostomy combined with continent ileocystoplasty:Two cases report

　2例の先天性神経因性膀胱症例に対し，Casaleが報告した回腸を用いるMitrofanoff法を行った。膀胱拡大術と同時に，約3,5cmの回腸を遊離し，中央部で腸間膜の反対側で全周の約80％を切開し，2つのセグメントにした．それぞれのセグメントを互いの反対側の腸間膜側で切開して1枚の板状にした後，ロール状に縫合して約12cmの新尿道を作成した。この方法は簡便で，十分な長さが得られる優れた方法と考えられた。

We present our initial experience of continent ileovesi-costomy developed by Casale in 1999. Two pediatric patients with congenital neurovesical dysfunction who had been managed with catheter-intubated cystostomy were treated. Their native urethras were not accessible to the poor compliant bladders because of cloacal ana-maly or steeply angulated posterior urethra with imper-forated anus respectively. Their urinary tracts were reconstructed with ileocystoplasty combined with a con-tinent ileovesicostomy A 3.5 cm of ileum was divided in half for 80% of circumference, leaving strip of bowel intact over mesentry.