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首页> 外文期刊>BJU international >A high easy-to-treat complication rate is the price for a continent stoma.
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A high easy-to-treat complication rate is the price for a continent stoma.

机译：易于治疗的高并发症发生率是大陆造口的价格。

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Objective To evaluate the conduit-related complications and their treatment in Mitrofanoff continent urinary diversion and antegrade colonic enema (ACE) procedures. Patients and methods The files of 53 patients (18 men and 35 women) in whom 58 continent stomas were created were retrospectively reviewed. Gender, age, age at the time of surgery, underlying disease, concomitant surgery, abdominal position of the stoma, follow-up, complications and treatment were assessed. The mean (sd) age at the time of surgery was 19 (13) years; 30 patients were aged <15 years and the mean follow-up was 2.8 (1.9) years. Fifty-three continent vesicostomy-type Mitrofanoff stomas were constructed and five ACE procedures performed. Forty-five stomas were in the umbilicus and 13 on the abdominal wall. For 45 conduits the appendix was used; in the other 13 a transverse tubularized ileal segment according to Monti was created. Results There were stoma-related complications in 19 patients (36%), with 27 in all and stomal stenosis accounting for more than half. Five patients had urinary leakage. The median time to the first complication was 9 months. Multiple regression analysis showed that gender and stoma location were the only significant determinants of the complication/follow-up ratio. Women had more complications than men and umbilical stomas fared worse than those on the abdominal wall. Age, underlying disease and type of stoma were not significantly related to the complication/follow-up ratio. The complication was treated by one procedure in 13 patients; four needed two and two needed three surgical revisions. Most complications were relatively easy to treat, i.e. dilatation in five, endoscopic incision in one, re-anastomosis in four, Y-V plasty in seven, a new channel in two, reimplantation in three, a bladder cuff in two for stomal leakage, and abdominoplasty in two. Only one stoma had to be abandoned. Conclusion The complication rate for continent small-diameter stoma is high. However, most complications are relatively easy to treat. Despite these complications, patient satisfaction remains high.
机译：目的评价米特法诺夫大陆转移尿和顺行结肠灌肠（ACE）手术中导管相关的并发症及其治疗方法。患者和方法回顾性分析了53例患者（18例男性和35例女性）的档案，其中创建了58个大陆气孔。评估了性别，年龄，手术时的年龄，基础疾病，伴随手术，造口的腹部位置，随访情况，并发症和治疗情况。手术时的平均（sd）年龄为19（13）岁; 30名年龄<15岁的患者，平均随访时间为2.8（1.9）年。建造了53个大陆膀胱造口术型Mitrofanoff气孔，并进行了五个ACE程序。脐带有45个气孔，腹壁有13个气孔。对于45个导管，使用附录。在其他13个中，创建了根据Monti的横向管状回肠段。结果19例患者中有造口相关并发症（36％），其中共27例为气道狭窄，占一半以上。 5例患者出现尿漏。首次并发症的中位时间为9个月。多元回归分析表明性别和气孔位置是并发症/随访率的唯一重要决定因素。女性的并发症比男性多，脐带气孔的情况比腹壁的情况要差。年龄，基础疾病和造口类型与并发症/随访率没有明显关系。 13例患者采用一种方法治疗并发症。其中四个需要两个，另外两个需要三个外科手术版本。大多数并发症相对较容易治疗，即扩张术5例，内窥镜切口1例，再吻合术4例，YV成形术7例，新通道2例，新通道3例，再植膀胱3例，用于造口渗漏，以及腹部成形术成两半。只需要丢弃一个造口。结论大陆小口径气孔并发症发生率较高。但是，大多数并发症相对容易治疗。尽管存在这些并发症，但患者满意度仍然很高。

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