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Related Experiment Videos

Neoplasia after ureterosigmoidostomy.

K Azimuddin1, I T Khubchandani, J J Stasik

  • 1Division of Colon and Rectal Surgery, Department of Surgery, Lehigh Valley Hospital, Allentown, Pennsylvania, USA.

Diseases of the Colon and Rectum
|December 29, 1999
PubMed
Summary

Neoplasia, including cancer, can develop after ureterosigmoidostomy. Regular colonoscopic screening is crucial for early detection and improved survival in patients with this urinary diversion.

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Area of Science:

  • Urology
  • Colorectal Surgery
  • Oncology

Background:

  • Neoplasia is a known complication following ureterosigmoidostomy.
  • Colorectal surgeons are increasingly involved in managing these patients due to the rarity of the condition for general surgeons.

Purpose of the Study:

  • To inform colorectal surgeons about managing neoplasia after ureterosigmoidostomy.
  • To familiarize colorectal surgeons with the unique pelvic anatomy post-ureterosigmoidostomy.

Main Methods:

  • MEDLINE search for ureterosigmoid tumors.
  • Critical analysis of theories on tumor cause and pathology.
  • Development of consensus guidelines for screening and treatment.

Main Results:

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  • Carcinoma incidence ranges from 2-15%; polyps are more common, following an adenocarcinoma sequence.
  • Pathogenesis involves urine-feces interaction, nitrosamine production, and DNA damage.
  • Latent period for carcinoma is 20-26 years; obstructive symptoms warrant investigation (CT, colonoscopy, barium enema).
  • Benign tumors treated by polypectomy; malignant tumors require excision of affected colon segment and ureteric implants.

    • Conclusions:

    • Lifelong close follow-up is essential for patients with ureterosigmoidostomy.
    • Screening aims to detect and treat neoplasia before malignancy, improving survival.
    • Annual colonoscopy, starting 5-6 years post-procedure, is the gold standard for surveillance.