THE PHYSIOLOGY OF GASTROCYSTOPLASTY - ONCE A STOMACH, ALWAYS A STOMACH

被引：20

作者：

BOGAERT, GA ^{[1
]}

MEVORACH, RA ^{[1
]}

KIM, J ^{[1
]}

KOGAN, BA ^{[1
]}

机构：

[1] UNIV CALIF SAN FRANCISCO,SCH MED,DEPT UROL,SAN FRANCISCO,CA 94143

来源：

JOURNAL OF UROLOGY | 1995年 / 153卷 / 06期

关键词：

BLADDER; STOMACH; HISTAMINE H2 RECEPTOR BLOCKADERS; PARASYMPATHOLYTICS;

D O I：

10.1016/S0022-5347(01)67383-X

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

To determine the physiology of acid secretion after gastrocystoplasty with the body of the stomach we performed a prospective standardized 3-day study in 13 children (median age 12.5 years) who had undergone bladder augmentation/replacement (median postoperative period 2 years). Urinary pH and titratable acid, and serum gastrin levels were measured after gastric distention with a meal and bladder distention with urethral filling at baseline and after medication with a histamine-2 receptor antagonist or an anticholinergic agent. Five children underwent cystoscopy and biopsy of the gastric and native segments of the gastrocystoplasty. In the fasting state pH was neutral, there was no titratable acid in the urine and serum gastrin level was normal in all cases. After a meal urinary acid secretion and serum gastrin level increased markedly. After each medication half of the patients demonstrated marked inhibition of urinary acid secretion after a meal while response was partial in the remainder. In none of the patients was there significant alteration in the pattern of gastrin secretion. Bladder distention did not result in urinary acid secretion or gastrin secretion. The cystoscopic and histological appearance of the native bladder and stomach segment of the gastrocystoplasty in the 5 patients was normal. We conclude that the gastric body segment used in gastrocystoplasty continues to secrete acid as though it were part of the stomach. The secretion of acid in the urine can be decreased with histamine-2 receptor antagonist or anticholinergic medication.

引用

页码：1977 / 1980

页数：4

共 21 条

[1]

Bogaert, Mevorach, Kogan, Urodynamics and clinical follow-up of 28 children after gastrocystoplasty, Brit. J. Urol., 74, (1994)

[2]

Kennedy, Adams, Mitchell, Rink, Piser, McNulty, Chronic renal failure and bladder augmentation: stomach versus sigmoid colon in the canine model, J. Urol., 140, (1988)

[3]

Adams, Mitchell, Rink, Gastrocystoplasty: an alternative solution to the problem of urological reconstruction in the severely compromised patient, J. Urol., 140, (1988)

[4]

Dykes, Ransley, Gastrocystoplasty in children, Brit. J. Urol., 69, (1992)

[5]

Gosalbez, Woodard, Broecker, Parrott, Massad, The use of stomach in pediatric urinary reconstruction, J. Urol., 150, (1993)

[6]

Gosalbez, Woodard, Broecker, Warshaw, Metabolic complications of the use of stomach for urinary reconstruction, J. Urol., 150, (1993)

[7]

Nguyen, Bain, Salmonson, Ganesan, Burns, Mitchell, The syndrome of dysuria and hematuria in pediatric urinary reconstruction with stomach, J. Urol., 150, (1993)

[8]

Johnson, Rai, Urine acid output as a test of completeness of vagotomy, Brit. J. Surg., 77, (1990)

[9]

Thomas, Eastham, Weaver, New noninvasive test of gastric acid secretion for use in children, Gut, 34, (1993)

[10]

Woodward, Lyon, Landor, Dragstedt, Physiology of the gastric antrum

← 1 2 3 →