Re: Macedo A Jr, Rondon A, Bacelar H, Leslie B, Ottoni S, Liguori R et al. An alternative channel for the Mitrofanoff principle based on transverse skin flaps: An extraperitoneal minimal invasive approach (the RPM technique). J Pediatr Urol 2012;8:437.

摘要

We congratulate the authors for evolving this innovative technique of skin-based flap for cutaneous diversion with continence based on crossing strips of rectus abdominis muscle. Our concern is that while the bowel is usually insensitive to touch, thermal or traumatic stimuli and is only sensitive to stretch [1], the same phenomenon may not apply to a skin-flap-based tube. The skin-based continent catheterizable stoma might be painful on repeated self-catheterization, which reduces the compliance of the patient, especially in the case of children on long-term follow up. Secondly, with time the crossing strips of rectus abdominis will try to retract back to their original location.