6533b7dafe1ef96bd126d854

RESEARCH PRODUCT

Colonic Conduit in Children

Oktay DemirkesenRudolf HohenfellnerMargit FischMichael StöckleRaimund Stein

subject

AdultMalemedicine.medical_specialtyTime FactorsAdolescentColonUrologyUrinary Diversionurologic and male genital diseasesStomal stenosisPostoperative ComplicationsRecurrent pyelonephritisHumansMedicineChildUpper urinary tractbusiness.industryUrinary Bladder DiseasesInfantColonic conduitUreterocolic anastomosismedicine.diseaseSurgeryBladder exstrophyStenosisChild PreschoolFemalebusinessComplicationFollow-Up Studies

description

Complication rates of up to 86.6% have been reported after creation of an ileal conduit. In contrast to others, we construct an antirefluxing isoperistaltic colonic for incontinent diversion in children.Between 1968 and 1989 a colonic conduit was created in 105 patients up to age 20 years for neurogenic bladder (76), bladder exstrophy (16) and other reasons (13). Long-term followup (minimum 5 years, mean 16.3 years, range 5 to 26) was possible in 84 patients (159 renal units).Early and late stenosis at the ureterocolic anastomosis, and stomal stenosis occurred in 7.6 and 15.5% of the cases, respectively. Renal calculi developed in 8.2% of the renal units. Eight kidneys without function after recurrent pyelonephritis, calculi or stenosis at the ureterocolic anastomosis were removed during followup. Compared to preoperative status 3 of the remaining 151 renal units had increased dilatation of the upper urinary tract at the last followup. A total of 31 patients had complications during followup and 18 underwent conversion to continent urinary diversion.When incontinent urinary diversion is necessary in children, a colonic conduit with the option of continent conversion should be created before deterioration of the upper urinary tract.

https://doi.org/10.1097/00005392-199609000-00098