Kinetic changes in experimental colonic urinary diversion

Strachan, John; Matthews, J.; Rees, Helen C.; Cooke, Timothy G.

doi:10.1002/bjs.1800741129

Cited by 21 publications

(5 citation statements)

References 13 publications

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“…Although other reports claim that this shift on the sialic mucin content could represent only an unstable colon epithelium exposed to additional aggression, there is enough evidence that greater increases in sialomucin are related to higher risk of developing colon cancer (7,(26)(27)(28)(29).…”

Section: Commentsmentioning

confidence: 99%

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: Commentsmentioning

confidence: 99%

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

et al. 2006

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“…On the basis of the reported results in this study, and the confounding results obtained from animal experi ments, we suggest that factors other than the increased endogenous formation of N-nitroso compound are re sponsible for colon carcinogenesis following ureterosig moidostomy [ 17], These factors may include the signifi cantly increased mitotic activity observed in all forms of intestinal anastomoses including urinary diversions [34][35][36], and the possible growth stimulation influence of urine on bladder carcinomas [37][38][39], These alternative theories to a nitrosamine-induced colon carcinogenesis would substantiate postulations by Roe et al [36] and Harzmann [27] that a similar risk of adenocarcinomas exists for all forms [36] of urinary diversions using ileum or colon, and that this risk is not confined to ureterosig moidostomy. Our results showing that ascorbic acid has no significant effect on endogenous nitrosation in urete rosigmoidostomy patients, and the recently reported promotion of bladder carcinogenesis in rats treated with ascorbic acid [40] strongly argue against its long-term use in ureterosigmoidostomy patients.…”

Section: Discussionmentioning

confidence: 91%

Effect of Vitamin C on Endogenous Formation of N-Nitrosamines in Ureterosigmoidostomy Patients

Kälble

Tricker²,

Hoang³

et al. 1991

Urol Int

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The bacterially catalyzed formation of nitrosamines in the rectosigmoid is a favorite theory for the increased risk of colon carcinomas following ureterosigmoidostomy. The urine/feces mixtures of 20 ureterosigmoidostomy patients were analyzed for nitrate, nitrite, volatile and nonvolatile nitrosamines prior to, and after, oral administration of vitamin C, a known nitrosation inhibitor. Following a 4-week period of daily ingestion of 2 g vitamin C (1 g in children) there was a slight, but not significant, decrease of volatile and nonvolatile nitrosamines and nitrite, as well as a nonsignificant increase in nitrate in the urine/feces of these patients. No correlation between the vitamin C concentration in serum or urine/feces mixture and the nitrosamine excretion was observed. These results suggest that the administration of vitamin C is not a suitable method for prophylaxis of endogenous nitrosation in ureterosigmoidostomy patients. Clinical and experimental findings implicate that factors other than nitrosamines play an important role in colon carcinogenesis of patients with ureterosigmoidostomies or other forms of urinary diversions using the small or large bowel.

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“…The proliferative instability at intestino-and urointestinal anastomoses is especially marked within the first 12 weeks of healing. Afterwards it decreases to normal again [30].…”

Section: Tumor Prophylaxismentioning

confidence: 93%