[Ileocolonic pouch with appendix in situ through umbilicus as a continent conduit].

OBJECTIVE

To try to use appendix in situ without any special treatment as a conduit of the continent cutaneous ileocolonic reservoir.

METHODS

An isolated ileocolonic segment, about 20 cm of terminal ileum and 20 cm of ascending colon, was detubularized by antimensenteric splitting and a pouch was completed by side-to-side anastomosis of the colon and the ileum loop. Both ureters were implanted into two separate submucosal tunnels of 3 cm long into the colon wall of the pouch. The appendix after tail was amputated was passed through the umbilicus hole with which the base of the cecum was sutured.

RESULTS

As a conduit of the pouch, the appendix had a good continent ability when 8 patients were followed up for 10 to 30 months after operation. It was easy and convenient for the patients to make self-catheterization. The mean capacities of the pouch were 500-700 ml and then the pressures were 20-45 cm H2O while it was filled. There were no definite complications such as urine leakage, stoma stenosis, ureter reflux, and hydroureteronephrosis.

CONCLUSION

The operation of the ileocolonic pouch with the appendix as a continent umbilical stoma is simple and easy to perform and has such advantages as good continent, convenient self-catheterization and provides a quality life for the patients undergoing total cystectomy.