The Role of Ureter in the Creation of Mitrofanoff Channels in Children

Abstract

Results of the ureteral Mitrofanoff channel seem somewhat less satisfactory than those of appendicovesicostomy but they remain acceptable and even comparable, strongly supporting its use in certain circumstances.

Split-appendix technique for simultaneous appendicovesicostomy and appendicocecostomy

“…A surgical revision rate of 22% was reported in 199 ileovesicostomies performed more than a 13-year period, with a mean follow-up of 28 months. The stomal continence and surgical revision rate for both the AC and AV in our series compare favorably with outcomes reported by other authors using a variety of surgical techniques [3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. The basic tenets of reconstructive surgery such as delicate tissue handling, preservation of blood supply, and performing a tension-free anastomosis probably contribute more to successful and reproducible outcomes rather than the tissue that composes the CCC.…”

“…This requires any additional channel being constructed from alternative tissue sources (ie, ureter or ileum) [6,7]. Occasionally, when the surgical anatomy is amenable, the appendix can be used for creation of both an AV and an AC.…”

Educational article: The Mitrofanoff procedure

“…In addition, the blood supply and mobility of the ureter are more limited than bowel. Since its description, the ureteral Mitrofanoff has been used successfully, but is fraught with higher complication rates of incontinence and stomal stenosis [14,15].…”

Experimental use of labial mucosa free graft urinary conduit in the Mitrofanoff principle

“…In creating a continent and catheterizable vesicostomy in children, the Mitrofanoff principle has been applied using the appendix when available, and more rarely, the ileum, the ureter, or others [2][3][4].…”