tailieunhanh - báo cáo khoa học: " Using Mitrofanoff’s principle and Monti’s technique as a surgical option for bladder augmentation with a continent stoma: a case report"

Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Using Mitrofanoff’s principle and Monti’s technique as a surgical option for bladder augmentation with a continent stoma: a case report | Cassini et al. Journal of Medical Case Reports 2011 5 49 http content 5 1 49 JOURNAL OF MEDICAL CASE REPORTS CASE REPORT Open Access Using Mitrofanoff s principle and Monti s technique as a surgical option for bladder augmentation with a continent stoma a case report Marcelo F Cassini Antonio A Rodrigues Jr Silvio Tucci Jr Adauto J Cologna Rodolfo B Reis Antonio CP Martins Haylton J Suaid Abstract 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 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 cm that was open longitudinally and reconfigured transversally Monti technique modeled by a 12-Fr urethral catheter and finally the distal stump .