肛門括約筋内結腸瘻を併用せる直腸膀胱術 : I 手術手技の要点と文献的考察

概要

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The rectal bladder combined with intrasphincteric perineal colostomy was made in the past 8 years in 44 patients. The present paper is concerned with the review of the surgical technique and its results that have appeared in the literature as well as the technique of the authors' own and several problems still remaining unsolved. Fine performance in implantation of the ureter to the isolated rectosigmoidal pouch is imperative for satisfactory postoperative courses. Nevertheless no paper has scrutinized and comparatively studied the so far available ureteral implantation techniques. Accordingly the technique of choice has not been determined. Techniques that the present authors have performed for ureteral anastomosis are : 1. Goodwin's technique 2. Sero-muscular folding technique 3. Cordonnier's technique 4. Others The best possible pathway of the intrasphincteric sigmoid to be constructed has not yet been deter-mined either, but this problem appears to be essential to achieve a satisfactory defecating function. Other techniques of urinary diversion, in which the anal sphincter is used to retain separate fecal and urinary continence, were also reviewed.
社団法人日本泌尿器科学会の論文
1974-11-20