Reuvers Sarah H M, van den Hoek Joop, Blok Bertil F M, de Oliveira Barbosa Telma C, Wolffenbuttel Katja P, Scheepe Jeroen R
Department of Urology, Erasmus MC, Rotterdam, The Netherlands.
Neurourol Urodyn. 2017 Jun;36(5):1325-1329. doi: 10.1002/nau.23045. Epub 2016 May 27.
To evaluate the long-term outcome of appendicovesicostomies and to present the frequency and timing of complications needing re-intervention.
In this retrospective study we included patients in whom an appendicovesicostomy was created at our institution between 1993 and 2011. Patients with a follow-up less than 1 year were excluded. Patient characteristics and conduit-related complications requiring re-intervention were collected.
One hundred and twenty-eight patients were included with mean age at initial surgery of 10.1 ± 3.9 years. Two thirds of the children had underlying neurogenic disease. The mean follow-up was 10.1 ± 4.8 years. All but one patient continued to use the catheterizable channel. Re-intervention for conduit-related complications was necessary in 32.0% of the patients. A second, third, and fourth re-intervention was required in respectively 10.9%, 2.3%, and 1.6%. The commonest complications were cutaneous/fascial stenosis in 14.8%, stenosis at conduit-bladder level in 9.4%, and stomal incontinence in 6.3% of the patients. The most performed re-interventions were stoma revision (in 16.4% of the patients), conduit revision (10.2%), and dilatation of a stenotic tract (4.7%). 63.3% of the re-interventions was superficial and/or endoscopic. The peak incidence of re-interventions was in the 1st year after conduit construction and decreased yearly.
Our study gives an overview of patients and their conduits developing from prepubertal children to young adults. During a mean follow-up of 10.1 years, roughly one third of the patients needed a re-intervention. We conclude that an appendicovesicostomy is an effective and durable treatment for whom transurethral clean intermittent catheterization is not feasible. Neurourol. Urodynam. 36:1325-1329, 2017. © 2016 Wiley Periodicals, Inc.
评估阑尾膀胱造口术的长期疗效，并阐述需要再次干预的并发症的发生频率及时间。
在这项回顾性研究中，我们纳入了1993年至2011年期间在我院接受阑尾膀胱造口术的患者。随访时间不足1年的患者被排除。收集患者的特征以及需要再次干预的导管相关并发症。
共纳入128例患者，初次手术时的平均年龄为10.1±3.9岁。三分之二的儿童患有潜在的神经源性疾病。平均随访时间为10.1±4.8年。除1例患者外，所有患者均继续使用可导尿通道。32.0%的患者因导管相关并发症需要再次干预。分别有10.9%、2.3%和1.6%的患者需要进行第二次、第三次和第四次再次干预。最常见的并发症是皮肤/筋膜狭窄（14.8%）、导管膀胱水平狭窄（9.4%）和造口失禁（6.3%）。最常进行的再次干预是造口修复（16.4%的患者）、导管修复（10.2%）和狭窄通道扩张（4.7%）。63.3%的再次干预是浅表性和/或内镜下的。再次干预的高峰发生率在导管构建后的第1年，且逐年下降。
我们的研究概述了从青春期前儿童到年轻成年人接受该手术的患者及其导管情况。在平均10.1年的随访期间，约三分之一的患者需要再次干预。我们得出结论，对于经尿道清洁间歇性导尿不可行的患者，阑尾膀胱造口术是一种有效且持久的治疗方法。《神经泌尿学与尿动力学》36:1325 - 1329, 2017。©2016威利期刊公司
