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Murine Distal Colostomy, A Novel Model of Diversion Colitis in C57BL/6 Mice
Published on: July 12, 2018
Urinary diversion and bowel cancer
Annals of the Royal College of Surgeons of England
|March 1, 1986
Summary
Urinary diversion surgery significantly increases cancer risk at the ureterocolic anastomosis, with tumors often originating from the colon. Bacterial presence in urine appears to be a key factor in this increased risk.
Area of Science:
- Urology
- Oncology
- Gastroenterology
Background:
- Urinary diversion is performed for benign diseases.
- The ureterocolic anastomosis is a potential site for malignancy.
- The role of bacterial flora and N-nitroso compounds in carcinogenesis is under investigation.
Purpose of the Study:
- To assess the cancer risk associated with urinary diversion.
- To investigate the origin and characteristics of tumors developing after urinary diversion.
- To explore the association between bacterial presence and carcinogenesis in urinary diversion patients.
Main Methods:
- Retrospective survey of 278 patients who underwent urinary diversion.
- Literature review on tumors associated with urinary diversion.
- Detection of nitrate-reducing bacteria and N-nitroso compounds in urine samples.
Main Results:
- An approximate 100-fold excess risk of cancer at the ureterocolic anastomosis was observed.
- No malignancies were detected in isolated ileal or colon conduits.
- Tumors were of colonic origin (adenoma, adenocarcinoma) with a long latency period (approx. 25 years).
- Nitrate-reducing bacteria and N-nitroso compounds were found in rectal and loop urines.
- Carcinogenesis appears linked to the presence of mixed bacterial flora, irrespective of diversion type.
Conclusions:
- Urinary diversion, particularly ureterocolic anastomosis, carries a substantial cancer risk.
- Colonic-origin tumors develop after a long latency period.
- The presence of mixed bacterial flora in urine is a critical factor in N-nitrosation and potential carcinogenesis.
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