Multiple failed closure of bladder in children with vesical exstrophy: Safety and efficacy of temporary ileal patch augmentation in assisting bladder closure
| Autor: | Abraham Mammen, Karthikeya K. Varma, Kolar Venkatesh Satish Kumar |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment lcsh:Surgery urologic and male genital diseases Ureterosigmoidostomy Bladder exstrophy Bladder closure medicine Surgical approach business.industry lcsh:RJ1-570 Mean age lcsh:Pediatrics Small bladder lcsh:RD1-811 medicine.disease female genital diseases and pregnancy complications Surgery medicine.anatomical_structure Early results Pediatrics Perinatology and Child Health failed primary bladder closure Sphincter Original Article business temporary ileal patch augmentation radical soft-tissue mobilization delayed primary bladder closure |
| Zdroj: | Journal of Indian Association of Pediatric Surgeons, Vol 19, Iss 4, Pp 222-226 (2014) Journal of Indian Association of Pediatric Surgeons |
| ISSN: | 1998-3891 0971-9261 |
| Popis: | Objective: The surgical approach to small bladder template in exstrophy bladder is difficult. Previously, many of these children underwent ureterosigmoidostomy and in recent times, the trend is to do a delayed primary closure. We have used ileal patch as a temporary cover for these small bladders with a view to encourage bladder growth and early results are encouraging. Materials and Methods: In five of the 45 children with bladder exstrophy managed by radical soft-tissue mobilization over 10 years, primary bladder closure was not possible due to repeated failed closures. A detubularized ileum was used to patch the bladder initially and after 4 months the patch was excised and bladder closure with sphincter repair was done in second stage. Results: In five children (three girls and two boys) the mean age at initial bladder closure was 14 months and mean age at ileal patch was 22 months. In four patients, the bladder grew facilitating closure and in one patient it failed. There were no complications with the use of gut in patch. Conclusion: A temporary ileal patch seems promising in managing failed bladder closure in exstrophy patients. Long-term studies are needed before such a technique can be used in all patients with failed primary bladder closures. |
| Databáze: | OpenAIRE |
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