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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2013/12/08 19:10:31」(JST)

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Not to be confused with Urine diversion.

Urinary diversion is any one of several surgical procedures to reroute urine flow from its normal pathway. It may be necessary for diseased or defective ureters, bladder or urethra, either temporarily or permanently. Some diversions result in a stoma.

Types[edit]

Nephrostomy from the renal pelvis
Urostomy from more distal origins along the urinary tract, with subtypes including:
- Ileal conduit urinary diversion (Bricker conduit)
- Indiana pouch
Neobladder to urethra diversion

Ureteroenteric anastomosis[edit]

A common feature of the three first, and most common, types of urinary diversion is the ureteroenteric anastomosis. This is the joining site of the ureters and the section of intestine used for the diversion.

The ureteroenteric anastomosis can be created in a number of different ways. There is the option of a refluxing or a non-refluxing type, and the two ureters can be joined into the intestinal segment either together or separately. The non-refluxing type has been associated with higher incidence of ureteroenteric anastomosis stricture, and there is doubt whether it has any advantages over the refluxing type. Therefore, many surgeons prefer the refluxing type which is simpler and apparently carries a lesser degree of complications.

Refluxing techniques include the Wallace and Wallace II and the Bricker end-to-side anastomosis. Non-refluxing techniques includes the Le Duc technique.

Complications[edit]

Complications include incisional hernia, neobladder-intestinal and neobladder-cutaneous fistulas, ureteroenteric anastomosis stricture, neobladder rupture and mucous formation.

References[edit]

Hautmann R (2003). "Urinary diversion: ileal conduit to neobladder". J Urol 169 (3): 834–42. doi:10.1097/01.ju.0000029010.97686.eb. PMID 12576795.
Macaluso JN Jr. External urinary diversion: pathologic circumstances and available technology. J Endourol. 1993 Apr;7(2):131-6. PMID 8518825

External links[edit]

www.fightbladdercancer.co.uk patient support site

eMedicine: Urinary Diversions and Neobladders

UpToDate Contents

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English Journal

Orthotopic neobladder vs. ileal conduit urinary diversion: A long-term quality-of-life comparison.

Goldberg H1, Baniel J2, Mano R2, Rotlevy G2, Kedar D2, Yossepowitch O2.
Urologic oncology.Urol Oncol.2015 Dec 3. pii: S1078-1439(15)00492-5. doi: 10.1016/j.urolonc.2015.10.006. [Epub ahead of print]
PURPOSE: The optimal form of urinary diversion following radical cystectomy remains controversial. We sought to compare the long-term health-related quality-of-life outcomes between patients with orthotopic neobladder and ileal conduit diversion (ICD).PATIENTS AND METHODS: We enrolled 95 patients fo
PMID 26670201

Long-term follow-up after ileocaecal continent cutaneous urinary diversion (Mainz I pouch): A retrospective study of a monocentric experience.

Khalil F1, Fellahi S1, Ouslim H1, Mhanna T1, El Houmaidi A1, Aynaou M1, Boteng PD1, Barki A1, Nouini Y2.
Arab journal of urology.Arab J Urol.2015 Dec;13(4):245-9. doi: 10.1016/j.aju.2015.09.004. Epub 2015 Oct 20.
OBJECTIVE: To assess the long-term follow-up after ileocaecal continent cutaneous reservoir (ICCR) and to review the late complications.PATIENTS AND METHODS: In all, 756 patients underwent an ICCR in our department, with long-term follow-up data available in 50 patients. The inclusion criterion was
PMID 26609442

Effect of Intraoperative Red Blood Cell Transfusion on Postoperative Complications After Open Radical Cystectomy: Old Versus Fresh Stored Blood.

Lee SJ1, Seo H1, Kim HC1, Lim SM1, Yoon SJ1, Kim HS2, Ku JH2, Park HP3.
Clinical genitourinary cancer.Clin Genitourin Cancer.2015 Dec;13(6):581-7. doi: 10.1016/j.clgc.2015.06.002. Epub 2015 Jun 15.
INTRODUCTION: Transfusion with red blood cells (RBCs) is associated with adverse clinical outcomes. We determined whether an intraoperative RBC transfusion is related to postoperative complications in patients undergoing open radical cystectomy. We also compared the effect of transfusion with fresh
PMID 26165733

Japanese Journal

Inferior Vena Cava Thrombosis Associated with a Distended Ileal Neobladder

Internal Medicine 54(8), 979-981, 2015
NAID 130005065273

回腸新膀胱造設術10年後に新膀胱小腸瘻を形成した1例

泌尿器科紀要 = Acta urologica Japonica 60(12), 631-633, 2014-12
NAID 120005528119

根治的膀胱全摘・回腸新膀胱造設術後の上部尿路CISに対し経皮的BCG灌流療法を施行した1例

泌尿器科紀要 = Acta urologica Japonica 60(9), 443-446, 2014-09
NAID 120005477657

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