A contribution to the history of medicine: transgastric urinary diversion for radiation- induced cystitis: three cases, one with a 15-year follow-up. Feasibility and limits
RUFFION A
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LERICHE A
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ARCHIMBAUD JP
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PAULHAC JB
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VIGUIER M
Seance of wednesday 10 may 2006 (pas de sujet Principal)
Abstract
The authors report three cases of transgastric urinary diversiondating from 1980, 1981 and 1989 respectively. They were undertakenfor a radiation-induced cystitis complicating a massive abdominalirradiation. This complication is a historical one and existsno longer due to the current progress of radiotherapy(conformational, hadrontherapy).Continence could not be obtained: the first two cases behaved like acystostomy, the third like a Bricker trans-intestinal cutaneous ureterostomy.Disorders of electrolyte balance (hypochloremic alkalosis withimportant hypokalaemia) were observed in the second patient. Theywere easily corrected by omeprazole. Therefore a preventive treatmentwith omeprazole was used in the third patient.The surgical technique is described. This operation is possible evenwhen the ureters are very short. Its indications are extremely rarecompared to other techniques of urinary diversion. However thestomach is a very good material that can be used with other intestinalsegments in composite urinary diversions.
