دورية أكاديمية
أعرض في EDS

Using Mitrofanoff's principle and Monti's technique as a surgical option for bladder augmentation with a continent stoma: a case report.

التفاصيل البيبلوغرافية
العنوان: Using Mitrofanoff's principle and Monti's technique as a surgical option for bladder augmentation with a continent stoma: a case report.
المؤلفون: Cassini MF; Department of Surgery and Anatomy, Division of Urology, Ribeirao Preto Medical School, Sao Paulo University, Sao Paulo, Brazil. marcelo.cassini@globo.com., Rodrigues AA Jr, Tucci S Jr, Cologna AJ, Reis RB, Martins AC, Suaid HJ
المصدر: Journal of medical case reports [J Med Case Rep] 2011 Feb 03; Vol. 5, pp. 49. Date of Electronic Publication: 2011 Feb 03.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: BioMed Central Country of Publication: England NLM ID: 101293382 Publication Model: Electronic Cited Medium: Internet ISSN: 1752-1947 (Electronic) Linking ISSN: 17521947 NLM ISO Abbreviation: J Med Case Rep Subsets: PubMed not MEDLINE
أسماء مطبوعة: Original Publication: [London] : BioMed Central, [2007-
مستخلص: Introduction: Hydronephrosis, reflux and renal failure are serious complications that occur in patients with neurogenic bladder associated with myelomeningocele. When the bladder compliance is lost, it is imperative to carry out surgery aimed at reducing bladder storage pressure. An ileocystoplasty, and for patients not suitable for intermittent catheterization, using the Mitrofanoff principle to form a continent stoma and the subsequent closure of the bladder neck, can be used. We report here, for the first time to the best of our knowledge, an association between two previously described techniques (the Mitrofanoff principle and the technique of Monti), that can solve the problem of a short appendix in obese patients.
Case Presentation: A 33-year-old male Caucasian patient with myelomeningocele and neurogenic bladder developed low bladder compliance (4.0 mL/cm H2O) while still maintaining normal renal function. A bladder augmentation (ileocystoplasty) with continent derivation principle (Mitrofanoff) was performed. During surgery, we found that the patient's appendix was too short and was insufficient to reach the skin. We decided to make an association between the Mitrofanoff conduit and the ileal technique of Monti, through which we performed an anastomosis of the distal stump of the appendix to the bladder (with an antireflux valve). Later, the proximal stump of the appendix was anastomosed to an ileal segment of 2.0 cm that was open longitudinally and reconfigured transversally (Monti technique), modeled by a 12-Fr urethral catheter, and finally, the distal stump was sutured at the patient's navel.After the procedure, a suprapubic cystostomy (22 Fr) and a Foley catheter (10 Fr) through the continent conduit were left in place. The patient had recovered well and was discharged on the tenth day after surgery. He remained with the Foley catheter (through the conduit) for 21 days and cystostomy for 30 days. Six months after surgery he was continent with good bladder compliance without reflux and fully adapted to catheterization through the navel.
Conclusion: The unpublished association between the Mitrofanoff and Monti techniques is feasible and a very useful alternative in urologic cases of derivation continent in which the ileocecal appendix is too short to reach the skin (i.e., in obese patients).
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تواريخ الأحداث: Date Created: 20110205 Date Completed: 20110714 Latest Revision: 20211020
رمز التحديث: 20240628
مُعرف محوري في PubMed: PMC3038960
DOI: 10.1186/1752-1947-5-49
PMID: 21291528
قاعدة البيانات: MEDLINE
الوصف
تدمد:1752-1947
DOI:10.1186/1752-1947-5-49