회맹장 요관 S결장문합술1 례

Abstract

Recently, continent internal urinary diversion has begun to achieve worldwide popularity. Herein, we report an experience with a 5 year-old female patient who had total urinary incontinence due to left ectopic ureter and vesicourethrovaginal fistula. The ileocecal ureterosigmoidostomy was performed as a staged procedure. The ileocecal segment including a part of ascending colon was isolated, an intussusception through the ileocecal valve was performed as the antireflux mechanism, and the ureters were spatulated and anastomosed side to side. The combined ureters then were sewn end to end to the ileum and the cecum was brought out on the skin as a stoma. Eleven months after first operation, the cecal stoma was taken down and discarded, and the remaining cecum containing the antireflux intussusception was anastomosed end to side to the lower sigmoid, internalizing the urinary diversion. After operation, she has gained perfect urinary control with no evidence of reflux, urinary tract infection and electrolyte imbalance for the 5 years follow up period. In conclusion, ileocecal ureterosigmoidostomy is a reasonable alternative to conventional ureterosigmoidostomy that may reduce the risk of development of cancer. Key word : ileocecal ureterosigmoidostomy, continent urinary diversion, cancer.