Indication of Augumentation and Ileocystoplasty for Colorectal Cancer with Infiltration of the Urinary Bladder

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  • 膀胱浸潤大腸癌に対する予測残存膀胱容量から見た膀胱拡大術の適応
  • ボウコウ シンジュン ダイチョウガン ニ タイスル ヨソク ザンゾン ボウコウ ヨウリョウ カラ ミタ ボウコウ カクダイジュツ ノ テキオウ
  • ボウコウ シンジュン ダイチョウガン ニ タイスル ヨソク ザンソン ボウコウ ヨウリョウ カラ ミタ ボウコウ カクダイジュツ ノ テキオウ

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Abstract

Colorectal cancers often infiltrate the urinary bladder, but combined resection of the main tumor and invaded region may have a good cure rate in such patients. Standard guidelines for selecting the treatment procedure to patients with colorectal cancer that has infiltrated the urinary bladder have not been established. The purpose of this study was to assess the postoperative bladder capacity for preserving the bladder function.We carried out nine operations in 8 patients with colorectal cancer involving the urinary bladder between 2001 and 2011. Direct closure was performed for 4 patients. Augmentation by ileocystoplasty was performed in 5 cases(1;recurrent case).Functional bladder volume is defined as 7ml/ kg, and we assumed the shape of a urinary bladder is a sphere. Expected post-operative bladder capacity was calculated using a formula based on these parameters. We investigated the post-operative urinary function and calculated the post-operative bladder capacity for these 9 cases. The post-operative bladder capacity of each patients ranged from 220 ml to 413ml. Although one patient's calculated post-operative bladder capacity was 223ml, the patient had good bladder function. However, another patient whose calculated post-operative bladder capacity was 220ml had disturbed function. The patient with a calculated post-operative bladder capacity of less than 220ml may have an operative indication for augmentation by cystoplasty. Postoperative results is 5 patients is surviving without recurrence and 3 patients survived over 5 years.

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