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Continent catheterizable conduits: which stoma, which conduit and which reservoir?
1Department of Paediatric Surgery, Great Ormond Street Hospital, London, UK. mcandrew@gosh.nhs.uk
Objective:
To assess the outcome of the various methods used in creating continent catheterizable conduits.
Patients And Methods:
The case notes were reviewed from 89 patients who underwent the formation of 112 continent catheterizable conduits.
Results:
Sixty-five conduits were Mitrofanoff and 47 were antegrade colonic enema (ACE); 21 patients had both. At a mean follow-up of 34 months, 95 (85%) conduits were still in use. There was no difference in complications between the Mitrofanoff and ACE conduits; 109 (97%) conduits were continent and stomal stenosis occurred 35 (31%). There was no significant difference relating to the conduit used, the reservoir, the stoma type or the stoma site. Only 39% of patients required no revisional surgery.
Conclusion:
Although urinary and fecal continence can be achieved in most patients there is a high burden of complications and revisional surgery. All patients should be counselled accordingly.