[Transappendicular continent cystostomy. Critical study apropos of 30 cases].
Continent vesicostomy using appendix has been performed in 30 incontinent children (myelo-meningocele). Surgical technique is described laying stress on the closure of the bladder neck and the appendix arrangement: appendix is implanted in the bladder with an antireflux sub-mucosal tunnel and the other end is hemmed to the skin. Self-catheterization is very easy. All patients are dry but the rate of complications was very high: 77%--8 leakage through the bladder neck imposing one or two re-operations. 10 uretero-hydronephrosis related to a small and hypertonic bladder: enterocystoplasty with good results--5 lithiasis--2 perforations. Success of this technique is closely linked to the construction of a large and low pressure bladder: 11 enterocystoplasty have been performed secondarily and 4 during the first operation. Actually 26/30 patients are well with normal kidneys and excellent comfort.


RESULTS
1 to 7 years.
D001065:Appendix / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D011183:Postoperative Complications; D013997:Time Factors; D001743:Urinary Bladder / Q000601:surgery; D014547:Urinary Diversion / Q000379:methods*
Cystostomie étanche trans-appendiculaire. Etude critique à propos de 30 observations.