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Value of colonoscopy after ureterosigmoidostomy
Surgery
|October 1, 1984
Summary
Ureterosigmoidostomy (US) increases colon cancer risk. Regular colonoscopies are crucial for early polyp and cancer detection in US patients to guide further treatment.
Area of Science:
- Urology
- Gastroenterology
- Surgical Oncology
Background:
- Ureterosigmoidostomy (US) is a urinary diversion technique with known complications.
- Despite risks like pyelonephritis and incontinence, US popularity is expected to rise.
- A significant increase in colonic carcinoma incidence has been reported following US.
Purpose of the Study:
- To evaluate the incidence of polyps and cancer at ureter implantation sites after US.
- To establish recommendations for surveillance and management of US patients.
- To assess the long-term outcomes of US concerning colorectal neoplasia.
Main Methods:
- Retrospective review of 110 patients who underwent US.
- Colonoscopic surveillance of 17 US patients, including histological analysis of polyps.
- Urologic follow-up and screening for occult blood.
Main Results:
- Invasive colon cancer occurred in 3 patients at the ureter implantation site.
- 41% of surveyed patients had polyps near the US site, histologically diagnosed as adenomas.
- One patient presented with superficial adenocarcinoma within large polyps.
Conclusions:
- US patients require regular, lifelong surveillance for colorectal polyps and cancer.
- Surveillance colonoscopy should commence early post-US.
- Alternative urinary diversion should be considered if dysplasia or cancer is detected.