Ileocolonic pouch with appendix in situ through umbilicus as a continent conduit
Abstract
OBJECTIVE: To try to use appendix in situ without any special treatment as a conduit of the continent cutaneous ileocolonic reservoir.
METHODS: An isolated ileocolonic segment, about 20 cm of terminal ileum and 20 cm of ascending colon, was detubularized by antimensenteric splitting and a pouch was completed by side-to-side anastomosis of the colon and the ileum loop. Both ureters were implanted into two separate submucosal tunnels of 3 cm long into the colon wall of the pouch. The appendix after tail was amputated was passed through the umbilicus hole with which the base of the cecum was sutured.
RESULTS: As a conduit of the pouch, the appendix had a good continent ability when 8 patients were followed up for 10 to 30 months after operation. It was easy and convenient for the patients to make self-catheterization. The mean capacities of the pouch were 500-700 ml and then the pressures were 20-45 cm H2O while it was filled. There were no definite complications such as urine leakage, stoma stenosis, ureter reflux, and hydroureteronephrosis.
CONCLUSION: The operation of the ileocolonic pouch with the appendix as a continent umbilical stoma is simple and easy to perform and has such advantages as good continent, convenient self-catheterization and provides a quality life for the patients undergoing total cystectomy.
How strong is the evidence?
Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 8 participants or records.
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