ぼうこう浸潤直腸癌に対するぼうこう合併切除，ぼうこう再建術（Ｉｌｅａｌ　ｃｙｓｔｏｐｌａｓｔｙ）　　Ｇｏｏｄｗｉｎの変法によるＡｕｇｍｅｎｔａｔｉｏｎ

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タイトル別名
  • Augmentation and Ileocystoplasty for Rectal Cancer Involving Urinary Bladder. Modified Goodwin's Method.
  • Modified Goodwin's Method
  • Goodwinの変法によるAugmentation

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Over the years, total pelvic exenteration has been the surgical approach for rectal cancer involving the urinary bladder.<BR>In the case of no bladder neak involvement, it is not necessary to combine total resection ; therefore urinary bladder preserving operation was performed on 6 cases of rectal cancer involving the urinary bladder. A modified preserving procedure for rectal cancer without bladder neck involving augmentation and ileocystplasty was described. Ileocystoplasty was done by so-called cup patch of Goodfin for augmentation of the resected urinary bladder wall. These procedures consisted of a ileal cup patch of about 25-30cm in length and anastomosis by Gambee suture to remnant bladder.<BR>Postoperative function tests revealed that the intra-bladder pressure was low but bladder constriction was almost normal.<BR>Ileocystoplasty with no opened segment of the ileum, namely, afferent loop, of about 10cm in length seems to contribute functionally to good prognosis of urine derivation because it may prevent regurgitation of urine, and it may be possible to make wide resection even if rectal cancer invades the bladder trigone.

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