title: Rectus sheath tunnels for continent stomas.
abstract: Continent stoma rectus sheath tunnel (CSRST) has been used in antegrade colonic enema (ACE) and urinary continent cutaneous diversion (UCCD) stomas to reduce leakage and to support a straight track for the continent conduit. All patients that underwent CSRST between 1995 and 2005 were identified and their case notes retrospectively reviewed. Patients were divided into two groups: the ACE group and the UCCD group. Demographic data, age at surgery and complications including stenosis and leakage were recorded. Forty patients underwent CSRST between 1995 and 2005. The mean age and standard deviation (SD) at surgery was 6.8 (2.1) years. Eighteen patients underwent ACE with a mean (SD) follow-up of 7.6 (3.1) years. No patient has faecal leakage. No patient had stomal revision, but one patient (5.5%) required an indwelling gastrostomy button to maintain patency. Twenty-two patients underwent UCCD with a mean (SD) follow-up of 8.1 (2.8) years. No patient developed urinary leakage. Two patients (9%) required revision of the stoma and one (4.5%) required an indwelling catheter because of recurring stomal stenosis. CSRST prevents stoma leakage. Revision surgery rate after CSRST is low, particularly after ACE reconstruction.
authors.affiliation: Department of Paediatric Urology, Central Manchester and Manchester Children's University Hospitals, NHS Trust, Manchester M27 4HA, UK. alan.dickson@cmmc.nhs.uk
authors.forename: Alan P
authors.initials: AP
authors.lastname: Dickson
authors.forename: Basem A
authors.initials: BA
authors.lastname: Khalil
authors.forename: Raimondo M
authors.initials: RM
authors.lastname: Cervellione
mesh_terms: D001065:Appendix; D002648:Child; D003559:Cystostomy / Q000379:methods*; D004733:Enema / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications; D017568:Rectus Abdominis / Q000601:surgery*; D012189:Retrospective Studies; D054047:Surgical Stomas; D016896:Treatment Outcome; D014547:Urinary Diversion / Q000379:methods*; D016476:Urinary Reservoirs, Continent