膀胱拡大術の臨床研究

(その1) ノベクタン噴霧のゼラチンスポンジを用いた萎縮膀胱拡大術の追試研究

抄録

Tsuji et al reported successful reconstruction of the bladder, utilizing gelatin sponge in 1970. They reinforced gelatin sponge by immersing it into 99 per cent ethyl alcohol for one hour and proved that the material was either absorbed or discharged after reconstruction of the bladder. Orikasa, after further experimental and clinical investigation, advocates that “novecutane” (plastic bandage spray) sprayed gelatin sponge is much more elastic and firmer than the alcohol immersed sponge. We tried cystoplasty using “nobecutane” reinforced gelatin sponge on two cases with contracted bladder and found that in suturing the sponge with the cut end of the contracted bladder, the “nobecutane” sprayed sponge was much more preferable than the alcohol immersed sponge. In both cases the bladder capacity was enlarged 3 to 4 times larger than the original. However, the detailed observation on our clinical cases demonstrated that “nobecutane” sprayed gelatin sponge was not absorbed spontaneously and some fragments of the sponge remained inside the bladder for a long time, forming a stone of the bladder in one case.
Thus, the authors are of the opinion that the prosthetic material should be evacuated easily and completely from the bladder during the short postoperative course, in order to prevent inflammation and calculous formation due to residual fragmens.