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Long‐term Management of Patients who have had Urinary Diversions into Colon
Author(s) -
SILVERMAN S. H.,
WOODHOUSE C. R. J.,
STRPCHAN J. R.,
CUMMING J.,
KEIGHLEY M.R. B.
Publication year - 1986
Publication title -
british journal of urology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 0007-1331
DOI - 10.1111/j.1464-410x.1986.tb05901.x
Subject(s) - medicine , anastomosis , etiology , complication , peptostreptococcus , gastroenterology , urinary system , surgery , biology , bacteroides , bacteria , genetics
Summary— Thirty‐four patients with urinary‐colonic diversions have been followed up for 13 to 41 years (mean 20.3). The commonest long‐term complication was hyperchloraemic acidosis (50%). The most serious was neoplasm at the anastomotic site: benign lesions occurred in three patients and carcinomas in two (15%). Staining for sialomucins in colonic biopsies adjacent to the anastomoses was positive in 17 of 19 patients. It has been suggested that this represents a pre‐malignant change. Analysis of faecal flora in 17 diverted patients and 27 controls revealed a significant difference in the carriage rate and viable count of Peptostreptococcus species. This finding has not been reported previously and the species could have a role in the aetiology of the neoplasms.