Division of Paediatric Urology, Clinic of Urology, University of Erlangen-Nürnberg, Krankenhausstrasse 12-14, D-91045 Erlangen, Germany.
J Pediatr Urol. 2012 Feb;8(1):87-91. doi: 10.1016/j.jpurol.2010.10.003. Epub 2010 Nov 2.
For cutaneous fixation of the continent catheterizable vesicostomy we present a new technique, in which the umbilicus is rotated caudally by 180° and the catheterizable channel is sutured to the umbilical cone. This procedure reduces the distance between the stoma entrance and the bladder.
Between 2001 and 2008, 67 patients underwent construction of a continent catheterizable vesicostomy. In 82% (n = 55), this was an appendicovesicostomy according to the Mitrofanoff principle. For 21 of these patients, later in the series (2005 onwards), the procedure involved rotation of the umbilicus. We evaluated cosmetic outcome and channel-related complication rates and compared the results between the two groups, with and without umbilical rotation.
The overall complication rate was 22.4% (n = 15); stoma stenosis occurred in eight cases. In the majority of cases with complications, endoscopic treatment was sufficient. The complication rate was significantly lower in the group with umbilical rotation compared to the other group (14.3% vs 26.1%, P < 0.02).
Umbilical rotation always enables cutaneous implantation of the vesicostomy in the umbilical pit and is a safe and straightforward procedure.
为了实现可通过皮肤进行的控尿性膀胱造口术，我们提出了一种新的技术，即将脐部向下旋转 180°，并将可通过导管进行的通道缝合到脐锥体上。该程序可以减少造口入口与膀胱之间的距离。
在 2001 年至 2008 年期间，有 67 名患者接受了可通过皮肤进行的控尿性膀胱造口术。其中，82%（n=55）是根据 Mitrofanoff 原理进行的阑尾膀胱造口术。对于这些患者中的 21 名（2005 年以后），后来采用了脐部旋转的程序。我们评估了美容效果和通道相关并发症的发生率，并比较了两组患者（有和没有脐部旋转）的结果。
总体并发症发生率为 22.4%（n=15）；有 8 例发生了造口狭窄。在大多数有并发症的病例中，内镜治疗就足够了。与另一组相比，有脐部旋转的组的并发症发生率明显较低（14.3%比 26.1%，P<0.02）。
脐部旋转始终可以将膀胱造口术的皮肤植入脐窝内，是一种安全且直接的程序。
