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Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer

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Split-appendix technique for simultaneous appendicovesicostomy and appendicocecostomy.

Brian A VanderBrink¹, Mark P Cain, Martin Kaefer

¹Division of Urology, Nationwide Children's Hospital, Columbus, OH 43205, USA. brianvanderbrink@yahoo.com

Journal of Pediatric Surgery

|January 18, 2011

Summary

This summary is machine-generated.

The split-appendix technique allows simultaneous urinary and fecal diversion (appendicocecostomy and appendicovesicostomy) with high continence rates. This method offers comparable outcomes to other techniques, avoiding bowel resection risks.

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Area of Science:

Urology
Pediatric Surgery
Gastroenterology

Background:

Urinary and fecal incontinence can be managed surgically using appendicocecostomy (AC) and appendicovesicostomy (AV).
Typically, the appendix can only serve one diversion, necessitating alternative tissues for the second channel.
The split-appendix technique offers a method to create both AC and AV simultaneously from a single appendix.

Purpose of the Study:

To evaluate the outcomes of the split-appendix technique for simultaneous creation of AC and AV.
To assess continence rates and the need for surgical revision after using the split-appendix technique.

Main Methods:

A retrospective review of patients undergoing simultaneous AC and AV using the split-appendix technique between 1999 and 2009.
The appendix was divided, with the proximal end used for AC and the distal end for AV.
Data collected included appendiceal length, continence status, and surgical revisions.

Main Results:

The split-appendix technique was used in 43 of 394 (11%) patients.
After a mean follow-up of 40 months, 43 of 43 ACs and 41 of 43 AVs achieved continence.
16 of 86 (19%) created channels required surgical revision.

Conclusions:

The split-appendix technique yields outcomes and revision rates comparable to other methods for continent reconstruction.
This technique is suitable for a subset of patients and avoids the risks associated with bowel resection.