在1984年到1996年之間，有20位患有腸道膀胱瘻管的病人在本院接受治療，將其病歷做一回顧性的分析與統計，我們發現幾點與先前國外的報告不同；1)本系列的女性病人較多；2)惡性腫瘤(包括直接侵犯及相關者)為引起瘻管的最主要原因；3)直腸為最常見的部位。氣尿症，尿糞症及小便經由肛門排出，可視為本疾病的特殊性徵候，因為只有三位病患無上述症狀中的任何一種。肺胱鏡檢為最有價值的診斷工具，可達到百分之77.8的診斷率。20位病患中，7位接受保守性治療，11位接受治癒性的外科治療，2位接受腸造瘻。7位接受保守性治療中的3個病人，雖合併有尿路感染，但仍然規則在門論追蹤達17，28及30個月。11 位接受治癬性外科治療的病人中，8個接受單一階段術式，有6個病人術後恢複良好(成功率為百分之75)。有1個病人接受二階段術式，2個病人接受三階段術式，也都獲得成功的治療，但相對地需要較長的療程。2位接受腸造瘻的病人中，接受迴腸造瘻的病人於術後兩個月死於敗血症，而接受結腸造瘻的病人在門診規則追蹤達36個月。我們建議在術前情況允許的病人，儘量考慮單一階段術式，而儘管需要較長的療程，多階段術式也能獲得良好的結果。

The records of 20 patients with acquired enterovesical fistulas treated at the Department of urology, National Tsiwan University Hospital between Jan. 1984 and Jan. 1996 were reviewed. We noted some differences from the previous literature: 1) there were more female patients in our series (55%);2) carcinoma (direct invasion or related) was the leading cause of the fistulas (70%); and 3) the most common enteric location was the rectum (35%). Pneumaturia, fecaluria, and urine per rectum were considered pathognomonic, and only 3 patients did not have any of these symptoms. Cystoscopy was the most valuable diagnostic tool and achieved a 77.8% diag-nosis rate. Of the 20 patients, 7received conservative management, 11 defintitive surgical inter-vention, and 2 enteric diversion only. Three of the conservatively treated patients had complica-tions with urinary tract infectio and had regular follow-up for 17,28, and 30 mo after diagnosis. Of the 11 patients operated on, 8 underwent a 1-stage procedure, and the postoperative course was uneventful for 6 patients (75% success rate). One patient underwent a 2-stage procedure, and 2 underwent a 3-stage procedure. They were all successfully treated, although prolonged treatment course was noted in this group. Two patients were treated with enteric diversion (ileostomy or colostomy). The Patient with ileostomy died 2 mo postoperatively due to sepsis, but the other with colostomy was regularly followed-up for 36 mo. We recommend a 1-stage opera-tion for patients in a good general operating condition, and multistage procedures also achieve good results in spite of the prolonged treatment course. (J Urol R.O.C., 9:138-143,1998)