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Guidelines for monitoring of patients with ureterosigmoidostomy

Woodhouse, CRJ; (2002) Guidelines for monitoring of patients with ureterosigmoidostomy. GUT , 51 V15 - V16.

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Abstract

Neoplasms can occur at the anastomosis of ureter and bowel probably only in the presence of faeces. In practice the only patients at risk are those with ureterosigmoidostomies or one of the variations, such as the Mainz II or Mansoura operations.The neoplasms are adenomas or adenocarcinomas. It is thought that adenomas develop first and subsequently undergo malignant degeneration. The observation that the mean latent period for the development of adenomas is 19.8 years and for carcinomas is 25.8 years suggests that this process takes a mean of six years.(1) It is uncertain whether the neoplasms arise from the intestinal or the ureteric epithelium or from the anastomosis itself. Although neoplasms other than adenomas and adenocarcinomas have been reported in patients with ureterosigmoidostomy, they are rare and probably a chance finding.Experimental evidence is difficult to interpret as some laboratory animals develop neoplasms very readily in urinary reservoirs and yet other animals develop few, thus the results cannot be translated from one species to another with confidence. However, it seems that when ureteric epithelium and colonic mucosa are anastomosed and exposed to faeces and urine, adenomas and adenocarcinomas are common. These neoplasms are rare when ileum is interposed between ureters and colon. When urine or faeces are excluded, a few neoplasms occur and seldom are malignant.

Type: Article
Title: Guidelines for monitoring of patients with ureterosigmoidostomy
Keywords: URINARY-DIVERSION, EXSTROPHY, BLADDER
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Surgery and Interventional Sci > Department of Targeted Intervention
URI: http://discovery.ucl.ac.uk/id/eprint/54147
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