title: Ureterosigmoidostomy: long-term results, risk of carcinoma and etiological factors for carcinogenesis.
abstract: We followed postoperatively 75 patients who underwent ureterosigmoidostomy between 1942 and 1987. Of the patients 30 were asked to undergo routine examination, including fiberoptic sigmoidoscopy with biopsy and analysis of a urine-feces slurry for nitrate, nitrite and nitrosamines in comparison to 20 control volunteers. After a mean observation of 14 years 7 months (1 to 46 years) 64.5% of the patients had bilaterally normal kidneys without any previous complications, 77.5% of the renal units being normal. Sigmoidoscopic biopsy revealed 3 carcinomas at the ureterocolonic junction resulting in an 8.5 to 10.5-fold increased risk of colon carcinoma compared to the general population. The excretion of nitrite and N-nitrosamines was increased, and nitrate excretion was decreased compared to healthy control volunteers, suggesting endogenous formation of nitrosamines by bacterially reduced nitrate and endogenous amines. The urological long-term results of ureterosigmoidostomy are similar to those of conduits. However, the increased incidence of colon carcinoma is not yet proved to be higher than in conduits.
authors.affiliation: Department of Urology, University of Heidelberg, Federal Republic of Germany.
authors.forename: T
authors.initials: T
authors.lastname: Kälble
authors.forename: A R
authors.initials: AR
authors.lastname: Tricker
authors.forename: P
authors.initials: P
authors.lastname: Friedl
authors.forename: R
authors.initials: R
authors.lastname: Waldherr
authors.forename: J
authors.initials: J
authors.lastname: Hoang
authors.forename: G
authors.initials: G
authors.lastname: Staehler
authors.forename: K
authors.initials: K
authors.lastname: Möhring
mesh_terms: D000328:Adult; D012809:Colon, Sigmoid / Q000601:surgery; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000209:etiology; D005500:Follow-Up Studies; D006801:Humans; D009566:Nitrates / Q000032:analysis; D009573:Nitrites / Q000032:analysis; D009602:Nitrosamines / Q000032:analysis; D011184:Postoperative Period; D012307:Risk Factors; D013997:Time Factors; D014517:Ureteral Obstruction / Q000453:epidemiology / Q000209:etiology; D014547:Urinary Diversion / Q000009:adverse effects*
chemical_list: D009566:Nitrates; D009573:Nitrites; D009602:Nitrosamines