Long-term follow-up of the appendix as outlet of ileocecum-colon continent re servoir / 中华泌尿外科杂志

ABSTRACT

Objective To evaluate the long-term effe ct of the continent urinary reservoir of ileocecum-colon with the appendix as out let. Methods Continent urinary reservoir of ileocecum-c olon with the appendix as outlet was performed in 46 patients with bladder tumor .Of them,21 patients (15 men and 6 women;mean age,57 years) were followed up by urodynamics for over 5 years.Pathologic grading showed G 2 in 12 cases and G 3 in 9;TNM staging showed T 3aN 0M 0 in 11 cases,T 3bN 0M 0 in 5,T 3bN 1M 0 in 3 and T 3bN 0M 1 in 2. Results Of the 21 cases,19 (95%) were of urinary continence.Catheterization was perfor med 4～5 times at daytime and 1～2 times at night; the volume was about 250～400 ml each time.On average the initial pressure of the reservoir was 28 cm H 2O (1 c m H 2O=0.098 kPa),and the maximal filling pressure was 36 cm H 2O;the correspo nding average capacity of the reservoir was 265 ml and 450 ml,respectively.The c losing pressure of the appendix outlet was 45 cm H 2O.One case developed lung m etastasis and underwent resection; 1 developed liver metastasis and died later.N o evidence of ureteral reflux and no hyperchloremic acidosis were observed. Conclusions Continent ileocecum-appendix pouch can be consi dered as an ideal form of urinary diversion characterized by lower internal pres sure and larger capacity of the urinary reservoir, and satisfactory continence.