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Query: UMLS:C0033377 (prolapse)
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Recently, the continent urinary reservoir which provides the patient with a better quality of life has become popular. Many types of reservoirs have been reported, but the optimal procedure remains to be established. From July 1987 through November 1988, we performed Kock pouch construction on 11 patients (ages 39 to 76 years). Between July 1989 and March 1991, 9 patients (ages 44 to 66 years) underwent Indiana pouch operation. The first 4 patients underwent ileal patch type, and the subsequent 5 underwent Heineke-Mikulicz type procedure. A one-stage radical cystectomy and continent urinary reservoir construction was performed on 19 patients, and bilateral cutaneous ureterostomy was converted to Kock pouch in one patient. There were no perioperative deaths, but reoperation was required for urinary leakage from the reservoir on one patient in each group. As the late complications in the Kock pouch group, one patient required revisional operation of the continent valve mechanism, 2 patients experienced intermittent prolapse of the nipple valve of the efferent limb, and 2 had malfunction of the afferent nipple valve. In the Indiana pouch group unilateral hydronephrosis was noticed in one patient, and 4 had mild difficulty of catheterization. Although 3 patients in both groups had mild urinary leakage, all patients had good quality of life with capacity of reservoir over 500 ml and with good renal function. We changed the type of operative procedure from Kock pouch to Indiana pouch because of the high complication ratio in the former.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Clinical studies on Kock continent urinary reservoir and Indiana continent urinary reservoir]. 152 2

We performed the Mikulicz procedure in 46 pediatric patients. Thirty-five were high-risk patients, 20 of whom had necrotizing enterocolitis. High risk was defined by the presence of peritonitis, intestinal perforation, poorly demarcated intestinal gangrene, or severe associated systemic illness. The remaining 11 patients had the procedure performed for technical reasons, most commonly a discrepancy in the size of the proximal distal limb ratio greater than 4:1. The procedure consisted of intestinal resection with double-barreled enterostomy, crushing of the spur between stomas, and subsequent lateral closure of the enterostomy. The mortality rate of 30% was due to the underlying disease and in no instance was death caused by a complication of the procedure. Complications (13%) were stricture or prolapse of the stoma and wound infection. Subsequent enterostomy closure in 32 patients had no mortality rate and a 3% complication rate. Because the risk of fatal anastomotic leak and peritonitis is very low, we prefer the Mikulicz procedure to all other intestinal anastomotic techniques for high-risk pediatric patients.
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PMID:A reappraisal of the Mikulicz enterostomy in infants and children. 705 4