Neoplasms of the Large Bowel Following Ureterosigmoidostomy

Sooriyaarachchi, Gamini S.

doi:10.1001/archsurg.1977.01370100028004

Cited by 56 publications

(12 citation statements)

References 30 publications

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“…The site of a developing carcinoma is usually at (Gillman, 1964;Oetjen et al, 1970) after ureterosigmoidostomy, although this is not always the case; in some cases the carcinoma develops some distance away and below the ureterocolic anastomosis (Sooriyaarachchi, 1977). The development of a carcinoma at the site of an anastomosis raises other questions of aetiological significance such as the mechanical trauma at operation (Gillman, 1964;McGregor, 1968), suture material and the interaction between two mucosal surfaces.…”

Section: Discussionmentioning

confidence: 99%

“…Carcinoma of the bowel following a ureterosigmoidoscopy was first reported over 50 years ago (Hammer, 1929). Since then over 40 similar cases have been reported (Sooriyaarachchi et al, 1977). In 1950 the cutaneous ileoureterostomy was introduced as a means of diverting the urine (Bricker, 1950).…”

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“…Cutaneous coloureterostomy as an alternative method of urinary diversion was popularised some 10 years later (Mogg, 1965) but as yet no reports have appeared of a carcinoma of the colon developing in such a patient. However, with ureterosigmoidoscopy the mean latent period between establishing the diversion and the appearance of a colonic neoplasm ranged between 20 and 25 years (Sooriyaarachchi et al, 1977;Stewart et al, 1981) for young patients but was less in older patients when the diversion had been performed for malignant conditions (Sooriyaarachchi etal., 1977). In view of the above findings it seems that the risk of Accepted for publication 3 June 1982.…”

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Changes in the Mucosa of Colon Conduits with Particular Reference to the Risk of Malignant Change

Moorcraft¹,

Duboulay²,

Isaacson³

et al. 1983

British Journal of Urology

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Intestinal suction biopsies were obtained in 15 infants and children with cutaneous colo-ureterostomies. The patients were subdivided into groups according to the length of time the conduit had been established, i.e. less than 5 years, 5 to 10 years, 10 to 15 years and over 15 years. The histological changes found were chronic inflammation with a dense infiltration of plasma cells and eosinophils. The changes were progressive and correlated with the length of time the conduit had been established. As persistent chronic inflammation is a precursor of malignancy, it seems likely that there is a risk of malignant change in these conduits. Regular follow-up of such patients is recommended and should include flexible fibreoptic endoscopy of the conduit.

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Section: Discussionmentioning

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Changes in the Mucosa of Colon Conduits with Particular Reference to the Risk of Malignant Change

Moorcraft¹,

Duboulay²,

Isaacson³

et al. 1983

British Journal of Urology

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“…The incidence is 100 to 550 times that of the general population2 with an overall lifetime risk of 5%; if the diversion is performed before the age of 25 years, the risk increases to 7000-fold 3. The latency is between six to 50 years after the procedure4with the mean time at 21 years; the median age at diagnosis is 33 years 5…”

Section: Discussionmentioning

confidence: 99%

Colonic carcinoma after ureterosigmoidostomy

Huang

McPherson²

2000

Postgraduate Medical Journal

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A symptomatic case of tongue base varices in a patient with portal hypertension secondary to liver cirrhosis is presented. There are no previously documented cases in the world literature. Oesophageal varices may not be the only source of expectorated blood in a patient with portal hypertension. (Postgrad Med J 2000;76:576-577) Keywords: portal hypertension; lingual; tongue; varicose vein Case reportAn 82 year old women with known portal hypertension secondary to cirrhosis of the liver was referred to the otolaryngology outpatient department with a two month history of daily haemoptysis and bloodstained pharyngeal secretions; this occurred mostly on early morning coughing. There was no history of weight loss, dysphagia, dysphonia, or throat pain. She had already been investigated for a pulmonary cause of the haemoptysis and none was found. In keeping with her history, liver function tests and the prothrombin time were abnormal. She also had a history of well controlled essential hypertension. Chest radiography showed cardiomegaly, but the jugular venous pressure was not raised and there was no other clinical manifestation of heart failure.Indirect laryngoscopy revealed varicose vessels in the tongue base, mainly on the left side (see fig 1). These appeared friable and one area revealed a propensity to bleed on examination. The rest of the ear, nose, and throat examination was normal.After perioperative cover with fresh frozen plasma, vitamin K, and tranexamic acid she underwent ablation of the varicosities using a 15 watt continuous carbon dioxide laser under general anaesthesia (see fig 2). She had an uneventful recovery and has remained symptom free. AnatomyThe dorsal lingual veins drain the tongue base through two or more tributaries. These course inferiorly, join together and form the lingual vein, which accompanies the lingual artery. These vessels pass between genioglossus and hyoglossus and the vein empties into the internal jugular vein just above the level of the greater cornu of the hyoid bone. (2) Periumbilical veins-veins contained in the falciform ligament anastomose with superior and inferior epigastric veins of the anterior abdominal wall. Excessive dilatation of these veins are evident as caput medusa.(3) Haemorrhoids-the superior rectal vein anastomoses with the middle rectal vein which drains into the internal iliac vein. In addition the middle rectal veins anastomose with the inferior rectal veins which drain into the internal pudendal vein. Increased shunting results in internal and external haemorrhoids. Thus, there is no recognised anastomosis between lingual venous drainage and the portal circulation. DiscussionA varicosity is a condition indicating an enlarged and tortuous vein. Previously described lingual varices referred to sublingual varices on the ventral surface of the tongue or floor of mouth. These were ascribed to the use of dentures, and vitamin C deficiency in an elderly population. 3Burket associated the occurrence of lingual varices with cardiorespiratory disease,...

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“…The risk of colon carcinoma after ureterosigmoidostomy has been estimated at about 5% [24,25]. This is about 150-500 times higher as com pared with the normal population without paying special attention to the operative technique with reflux pre vention and the geographic and racially correlated inci dence of colon carcinoma [24][25][26], Thus screening is man datory. A colonoscopy has to be performed 5 years after ureterosigmoidostomy and repeated annually.…”

Section: Discussionmentioning

confidence: 99%