1979
DOI: 10.1111/j.1464-410x.1979.tb03580.x
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Tumour of the Colon as a Late Complication of Ureterosigmoidostomy for Exstrophy of the Bladder

Abstract: Two cases of cancer of the colon have occurred recently in our series of 38 patients with exstrophy of the bladder treated by ureterosigmoidostomy. Twenty-six and 14 years elapsed between the original operation and the diagnosis of malignancy. Since 1929 the literature contains reports of 55 patients who have developed bowel neoplasms as a late complication of this form of diversion. The operation was performed for exstrophy in 35 of these, in whom the resulting tumour at the anastomotic site was malignant in … Show more

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Cited by 98 publications
(34 citation statements)
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“…The risk of colon carcinoma after ureterosigmoidostomy has been estimated at about 5% [24,25]. This is about 150-500 times higher as com pared with the normal population without paying special attention to the operative technique with reflux pre vention and the geographic and racially correlated inci dence of colon carcinoma [24][25][26], Thus screening is man datory. A colonoscopy has to be performed 5 years after ureterosigmoidostomy and repeated annually.…”
Section: Discussionmentioning
confidence: 99%
“…The risk of colon carcinoma after ureterosigmoidostomy has been estimated at about 5% [24,25]. This is about 150-500 times higher as com pared with the normal population without paying special attention to the operative technique with reflux pre vention and the geographic and racially correlated inci dence of colon carcinoma [24][25][26], Thus screening is man datory. A colonoscopy has to be performed 5 years after ureterosigmoidostomy and repeated annually.…”
Section: Discussionmentioning
confidence: 99%
“…Formerly, ureterosigmoidostomy [12] and rectal bladder operation [13] were thought to satisfy the above three conditions; however, the former opera tion has fallen into disfavor because of a high incidence of electrolyte imbalance [17] and high incidence of sigmoid colon cancer [18], while the latter operation is frequently complicated by renal impairment and nocturnal urinary incontinence [19], Until recently, ileal conduit operation has been the principle method of urinary diversion. How ever, operative methods using only the ileum and both terminal ileum and right hemicolon which satisfy at least conditions 1 and 2 above have become popular paralleling the progress in stapling devices and artificial materials for operation in recent years.…”
Section: Discussionmentioning
confidence: 99%
“…Some authors use a seg ment of colon for enterocystoplasty [6,11,14], Like oth ers, we prefer to use ileum as a substitute [1,3,15], As shown by Berglund et al [15] ileum has a higher distensibility and a lower motor activity which is more compat ible than colon, which will generate high-pressure contrac tions that might stimulate the detrusor resulting in urgen cy. Ileal surgery carries less complications than colonic surgery and finally a greater theoretic probability exists to develop cancer in colonic mucosa than in ileum [16], Owing to the cancer risk, several authors recommend long-term endoscopic follow-up of enterocystoplasty pa tients [4,9]. Some need to self-catheterize postoperatively, and, since it is difficult to predict which patients will need CIS, it is necessary to inform and train all patients in this tech nique before the operation [5], From the present study, there seems to be a tendency that patients with neuropath ic disease have a higher risk for CIS, which might be explained by a greater postoperative bladder volume (mean = 364 ml) compared to the nonneuropathic pa tients (mean = 246 ml).…”
Section: Discussionmentioning
confidence: 99%