Mitrofanoff procedure in children: use of the appendix and VQZ plasty seems to minimize complications

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PURPOSE: Variations around Mitrofanoff technique exist for continent catheterizable channel (CCC). The present study aims to analyze CCC complications within our patient cohort, in which the appendix was given preference to the maximum. METHODS: Retrospective review of pediatric patients who had CCC surgery in our institution (2007-2019). A nine-item questionnaire was sent to assess current use of their CCC. RESULTS: Among the 31 patient-cohort, appendix was used in 30, with a VQZ plasty in the right lower quadrant in 29. Postoperatively, seven CCC dysfunctions occurred in six patients between one month and nine years (four catheterization difficulties, one CCC stenosis at bladder level, one CCC incontinence, one parastomal hernia, no superficial stenosis). Of these complications, two were managed conservatively, two endoscopically, and three by open surgery. 21/23 surveys were returned: mean age of responders was 15 years, 97% used their CCC regularly, and none complained of CCC incontinence. CONCLUSION: This study shows a low revision rate for CCC dysfunction, with over half of the cases effectively managed through conservative or endoscopic means. It seems that following a stringent protocol with meticulous surgical technique and standardized postoperative care by a specialized nursing team reduces the risk of CCC complications.

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