Induction of Carcinoma at Ureterosigmoid Anastomosis–with and without Faecal Stream

Miersch, W.-D.; Vogel, J.

doi:10.1111/j.1464-410x.1992.tb15596.x

Cited by 4 publications

(3 citation statements)

References 26 publications

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“…However, metaplasia was found in the animals of the operated group. Other experimental reports confirm this finding and have suggested the presence of an unstable, artificially produced borderline tissue between transitional cell epithelium and mucosal irritation (17,18). Also chronic inflammation in 15 children submitted to colon-ureterostomies has been reported and established as a precursor of malignancy (5).…”

Section: Commentssupporting

confidence: 69%

Histological and histochemical changes of the intestinal mucosa at the urothelial-enteric anastomotic site

et al. 2006

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Objective: The incorporation of bowel segments for urinary tract reconstruction may induce intestinal mucosal changes with the development of metabolic, nutritional, gastrointestinal and carcinogenic complications. The early histological and histochemical changes of the intestinal mucosa in contact with the feces-urine mixture, are evaluated in the present study. Materials and Methods: Twelve rats (operated group) were submitted to a vesico-colonic anastomosis, and 10 rats (control group) underwent a sham operation (the colon was opened and immediately sutured). On the operated group, the left colon was divided into 3 equal portions and the middle segment was used for the bladder-colonic anastomosis. After 20 weeks, the animals were sacrificed and the entire left colon in each group, as well as the bladder and the vesico-colonic anastomosis in the operated group, was removed. The proximal, middle (anastomotic site in the operated group and sutured portion in the control group) and distal colon were used for histological and histochemical studies. Results: Metaplasia, chronic inflammatory process and fibrosis were significantly greater at the anastomotic site compared to the middle segment of the control group. There were no differences in both groups in terms of dysplasia, atrophy and hypertrophy either on the proximal, middle or anastomotic area and distal portion of the left colon. All animals in the operated group showed a reduced presence of sulfomucin and an increase in the sialomucin content. Conclusion:The histological changes observed in this study may suggest a precancerous phenomenon.

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Section: Commentssupporting

confidence: 69%

Histological and histochemical changes of the intestinal mucosa at the urothelial-enteric anastomotic site

et al. 2006

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“…The only significant difference between the two groups was a varying tumor spectrum with 5 (12.5%) urothelial carcinomas, 4 adenocarcinomas (10%), and 1 adenoma (2.5%) in the colostomy group versus 11 adenocarcinomas (27.5%) and 2 adenomas (5%) in the vesicosigmoidostomy group [12]. Both the incidences and the tumor spectrum of the two groups were confirmed by animal experiments of Miersch and Vogel [16].…”

Section: Introductionmentioning

confidence: 89%

“…The key to the etiology of these tumors seems to be the localisation directly at the urocolonic anastomosis. Miersch found an extremely unstable borderline of transitional and colon epithelium with bladder and colon epithelium protruding beyond the anastomosis [16]. Both urothelial and adenocarcinomas in humans [6] as well as in rats [12] occur at the anastomosis.…”

Section: Etiologymentioning

confidence: 99%

Carcinogenesis Following Urinary Diversion

Kälble¹,

Riedmiller²

1996

Aktuel Urol

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Tumor induction and prophylaxis following different forms of intestinal urinary diversion in a rat model

et al. 1995

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Eighty Wistar rats were randomized into two groups. In group 1 vesicosigmoidostomy with proximal colostomy was performed, in group 2, vesicosigmoidostomy. The total tumor incidence did not significantly (group 1 10/40, 25%; group 2 13/40, 32.5%). The tumor spectrum differed, with more adenocarcinomas in group 2 (11/40, 27.5% vs 4/40, 10%; P = 0.047) and urothelial carcinomas only in group 1 (5/40, 2.5%). One hundred and ten other Wistar rats were randomized into three groups. Animals in group A received vesicoileosigmoidostomy, group B, two-step vesicosigmoidostomy with initial separation of urine and the urocolonic anastomosis, group C, vesicosigmoidostomy. Significantly fewer adenocarcinomas were observed in group A (2/40, 5%) than in group B (16/40, 40%; P < 0.002) and group C (9/30, 30%; P < 0.007). These results indicate a similar cancer risk in all continent forms of urinary diversion, at least via colon. Ileal interposition seems to be an effective carcinoma prophylaxis following ureterosigmoidostomy. The proliferative instability at the urointestinal anastomosis is crucial for the pathogenesis and prophylaxis of this form of carcinogenesis, whereas urine seems to play only a minor role.

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Induction of Carcinoma at Ureterosigmoid Anastomosis–with and without Faecal Stream

Cited by 4 publications

References 26 publications

Histological and histochemical changes of the intestinal mucosa at the urothelial-enteric anastomotic site

Histological and histochemical changes of the intestinal mucosa at the urothelial-enteric anastomotic site

Carcinogenesis Following Urinary Diversion

Tumor induction and prophylaxis following different forms of intestinal urinary diversion in a rat model

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