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Titolo:
The Yang-Monti ileovesicostomy: a problematic channel?
Autore:
Narayanaswamy, B; Wilcox, DT; Cuckow, PM; Duffy, PG; Ransley, PG;
Indirizzi:
Great Ormond St Hosp Children, Dept Paediat Urol, London WC1N 3JH, EnglandGreat Ormond St Hosp Children London England WC1N 3JH WC1N 3JH, England
Titolo Testata:
BJU INTERNATIONAL
fascicolo: 9, volume: 87, anno: 2001,
pagine: 861 - 865
SICI:
1464-4096(200106)87:9<861:TYIAPC>2.0.ZU;2-T
Fonte:
ISI
Lingua:
ENG
Soggetto:
EARLY CLINICAL-EXPERIENCE; MITROFANOFF PRINCIPLE; CONTINENT VESICOSTOMY; URINARY; CHILDREN; CATHETERIZATION; RECONSTRUCTION; CREATION; TUBE;
Keywords:
ileovesicostomy; Monti procedure; appendicovesicostomy; Mitrofanoff; catheterization problems;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
20
Recensione:
Indirizzi per estratti:
Indirizzo: Wilcox, DT Great Ormond St Hosp Children, Dept Paediat Urol, Great Ormond St, London WC1N 3JH, England Great Ormond St Hosp Children Great Ormond St London England WC1N 3JH
Citazione:
B. Narayanaswamy et al., "The Yang-Monti ileovesicostomy: a problematic channel?", BJU INT, 87(9), 2001, pp. 861-865

Abstract

Objective To compare the differences in the quality of Mitrofanoff channels created using appendix and re-tubularized small bowel (the Yang-Monti ileovesicostomy). Patients and methods The case-notes were reviewed retrospectively for all patients who underwent a Mitrofanoff procedure using either appendix or small bowel, over a 5-year period from June 1994 to July 1999. Results In all, 92 patients underwent 94 Mitrofanoff procedures; the appendix was used in 69 and small bowel in 25. The underlying diagnoses were exstrophy-epispadias complex (38), neuropathic bladder (21), anorectal malformations and cloacal anomalies (15), posterior urethral valves (nine) and miscellaneous (nine), The mean (range) age at operation was 9.2 (1.1-18.3) years. The mean (range) follow-up for the appendix group was 37(6.7-65)months and for the Monti group 25(6-66) months. Catheterization problems occurred in 18 (27%) patients from the appendix group; two needed an adjustment of technique, six dilatation and 10 revision. Stomal stenosis occurred in 10 (15%) patients, bladder level stenosis in four (6%) and conduit necrosis in two, Catheterization problems were reported in 15 (60%) patients from the Monti group; ti ire needed revision, three dilatation and seven are being managed conservatively. The incidences of stomal stenosis (four, 16%) and bladder level stenosis (two, 8%) were comparable with the appendix group, In addition, two patients had distal channel (sub-stomal) stenosis and two had mid-channel stenosis. The problem unique to the Yang-Monti channel was a pouch-like dilatation in seven patients (28%), all of whom presented with catheterization problems; five are being managed conservatively and two have needed pouch resection. Stomal prolapse occurred in five (7%) patients in theappendix group, but in none of the Monti group. Conclusions The appendix is the conduit of choice for a Mitrofanoff procedure. Re-tubularized small bowel conduits have a considerably higher incidence of catheterization problems. Anatomical factors may contribute to the unique incidence of pouch formation.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 14/07/20 alle ore 08:59:51