Cystoplasty Using the Ileocecal Portion after Resection of Rectosigmoid Cancer Fixed to the Cystic Wall

Yasuji Takao¹⁾, Tetsuo Futami¹⁾, Sakae Miyake¹⁾, Nozomi Kawasato²⁾, Shuhei Ota³⁾

¹⁾Department of Surgery, Kenwakai Otemachi Hospital
²⁾Department of Surgery, Kenwakai Nakabaru Hospital
³⁾Department of Urology, Mihagino Hospital

The patient was a 47-year-old man who underwent reconstruction of the urinary bladder following low anterior resection and subtotal cystectomy for rectosigmoid cancer in May, 1990. The tumor was firmly adhering to the ileum nd the bladder. It could be resected en bloc with a part of the ileum and the urinary bladder wall, preserving the bladder neck. The histopathological findings showed that the tumor was well differentiated adenocarcinoma with se, n₁, ly₁, v₀, ow(-), aw(-) and ew(-). Reconstruction of the bladder was performed by ileocecal cystoplasty, accompanied by anastomosis of the cecum to the bladder neck and the ileum to the ureters by the submucosal tunnel procedure, and it led to voluntary urination. The volume of the reconstructed bladder is 260 ml, the residual urine volume is 0 ml and he urinates 4 or 5 times a day at present, 6 years after the operation. Hydronephrosis, urinary tract infection, incontinence in the daytime, and recurrence have not occurred. Cases of total cystectomy preserving voiding function for invasion of colorectal cancer to the bladder have rarely been reported, but we believe this procedure is of great benefit for improving the quality of life of the patients after pelvic exenteration.

Key words
colorectal cancer invading the bladder, pelvic exenteration, reconstruction of the urinary bladder

Reprint requests
Yasuji Takao Department of Surgery, Kenwakai Otemachi Hospital
15-1 Ohtemachi, Kokurakita-ku, Kitakyusyu, 803 JAPAN

Accepted
July 2, 1997

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