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Half-Century Follow-up after Ureterosigmoidostomy in Early Childhood.
MedLine Citation:
PMID:  23220244     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
PURPOSE: To study the clinical outcome, especially in regard to colorectal adenocarcinoma (CRAC), of patients operated on in early childhood with ureterosigmoidostomy (USS) during the period 1944-1961. PATIENT AND METHOD: Twenty-five patients were consecutively operated on with USS at a mean-age of 3.1 years. The most common indication for USS was Bladder Exstrophy Epispadia Complex (BEEC). The study period ended in 2010. Patient files were retrospectively evaluated, telephone personal interviews performed and colorectal histology revalued. One girl, deceased 4 days postoperatively, was excluded from follow-up. RESULTS: At 2010, 17/24 patients with a mean-age of 59 years (48-67) were alive and 2 of them still had the USS in function. Twenty were re-diverted after a mean-period of 30 years and a mean-age at re-diversion of 33 years. Seven patients developed invasive CRAC and 1 CRAC in situ. Five of them died due to generalized CRAC. Mean-time from USS to diagnosis of invasive CRAC was 38 years (range 23-55). Three were diagnosed 1, 21 and 25 years after re-diversion. One patient with CRAC in situ was 22 years of age at time for polyp-resection, 20 years after re-diversion. One patient developed a carcinoid. Of the 7 cases with invasive CRAC, 6 were low differentiated. CONCLUSION: After a half-century follow-up in 25 individuals operated on with USS during childhood, 17 were still alive and 20 had been re-diverted. Compared to the general Swedish population, the risk to develop CRAC was increased 42 times and the incidence of low differentiation was extremely high.
Authors:
Louise Pettersson; Johan Tranberg; Kate Abrahamsson; Silas Pettersson; Ulla Sillen; Olof Jonsson
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-12-4
Journal Detail:
Title:  The Journal of urology     Volume:  -     ISSN:  1527-3792     ISO Abbreviation:  J. Urol.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-12-10     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0376374     Medline TA:  J Urol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Pathology and Cytology, Hallands hospital Halmstad, Sweden.
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