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Double barreled wet colostomy: initial experience and literature review.

Salgado-Cruz L, Espin-Basany E, Vallribera-Valls F, Sanchez-Garcia J, Jimenez-Gomez LM, Marti-Gallostra M, Garza-Maldonado A - ScientificWorldJournal (2014)

Bottom Line: Six patients had a urinary tract reconstruction with the DBWC technique, 5 male patients and one female patient.Age range was from 20 to 77 years, with a medium age 53.6 years.The most frequent complication presented was a pelvic abscess in 3 patients (42.85%); all complications could be resolved with a conservative treatment.

View Article: PubMed Central - PubMed

Affiliation: Colorectal Surgery Unit, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain ; Instituto de Cirugía Centro Médico Zambrano Hellion-Tec Salud, Batallón de San Patricio 112, Real de San Agustín, 66278 San Pedro Garza García, NL, Mexico ; School of Medicine and Health Sciences, Tecnológico de Monterrey, Mexico.

ABSTRACT

Background: Pelvic exenteration and multivisceral resection in colorectal have been described as a curative and palliative intervention. Urinary tract reconstruction in a pelvic exenteration is achieved in most cases with an ileal conduit of Bricker, although different urinary reservoirs have been described.

Methods: A retrospective and observational study of six patients who underwent a pelvic exenteration and urinary tract reconstruction with a double barreled wet colostomy (DBWC) was done, describing the preoperative diagnosis, the indication for the pelvic exenteration, the complications associated with the procedure, and the followup in a period of 5 years. A literature review of the case series reported of the technique was performed.

Results: Six patients had a urinary tract reconstruction with the DBWC technique, 5 male patients and one female patient. Age range was from 20 to 77 years, with a medium age 53.6 years. The most frequent complication presented was a pelvic abscess in 3 patients (42.85%); all complications could be resolved with a conservative treatment.

Conclusion: In the group of our patients with pelvic exenteration and urinary tract reconstruction with a DBWC, it is a safe procedure and well tolerated by the patients, and most of the complications can be resolved with conservative treatment.

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Related in: MedlinePlus

Schematic representation of double barreled wet colostomy.
© Copyright Policy - open-access
Related In: Results  -  Collection


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fig1: Schematic representation of double barreled wet colostomy.

Mentions: In all patients, and once the pelvic exenteration was performed, both urethers are freed from the retroperitoneum with care to protect their blood supply. The last 15 to 20 cm of colon is used as urinary reservoir. Muscular and submuscular dissection are made in the taenia, and an antireflux ureterocolic anastomosis is made; ureters are sutured with single J catheters placed. A loop colostomy is constructed with eversion of the fecal stream. Finally, the urinary reservoir is fixed to the retroperitoneum in order to avoid pulling from the ureterocolonic sutures (Figure 1). The urethral catheters are left in place for three weeks and removed previous radiologic assessment that confirms that no complications are present in the ureterocolonic anastomosis.


Double barreled wet colostomy: initial experience and literature review.

Salgado-Cruz L, Espin-Basany E, Vallribera-Valls F, Sanchez-Garcia J, Jimenez-Gomez LM, Marti-Gallostra M, Garza-Maldonado A - ScientificWorldJournal (2014)

Schematic representation of double barreled wet colostomy.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4269158&req=5

fig1: Schematic representation of double barreled wet colostomy.
Mentions: In all patients, and once the pelvic exenteration was performed, both urethers are freed from the retroperitoneum with care to protect their blood supply. The last 15 to 20 cm of colon is used as urinary reservoir. Muscular and submuscular dissection are made in the taenia, and an antireflux ureterocolic anastomosis is made; ureters are sutured with single J catheters placed. A loop colostomy is constructed with eversion of the fecal stream. Finally, the urinary reservoir is fixed to the retroperitoneum in order to avoid pulling from the ureterocolonic sutures (Figure 1). The urethral catheters are left in place for three weeks and removed previous radiologic assessment that confirms that no complications are present in the ureterocolonic anastomosis.

Bottom Line: Six patients had a urinary tract reconstruction with the DBWC technique, 5 male patients and one female patient.Age range was from 20 to 77 years, with a medium age 53.6 years.The most frequent complication presented was a pelvic abscess in 3 patients (42.85%); all complications could be resolved with a conservative treatment.

View Article: PubMed Central - PubMed

Affiliation: Colorectal Surgery Unit, Vall d'Hebron University Hospital, Universitat Autonoma de Barcelona, Barcelona, Spain ; Instituto de Cirugía Centro Médico Zambrano Hellion-Tec Salud, Batallón de San Patricio 112, Real de San Agustín, 66278 San Pedro Garza García, NL, Mexico ; School of Medicine and Health Sciences, Tecnológico de Monterrey, Mexico.

ABSTRACT

Background: Pelvic exenteration and multivisceral resection in colorectal have been described as a curative and palliative intervention. Urinary tract reconstruction in a pelvic exenteration is achieved in most cases with an ileal conduit of Bricker, although different urinary reservoirs have been described.

Methods: A retrospective and observational study of six patients who underwent a pelvic exenteration and urinary tract reconstruction with a double barreled wet colostomy (DBWC) was done, describing the preoperative diagnosis, the indication for the pelvic exenteration, the complications associated with the procedure, and the followup in a period of 5 years. A literature review of the case series reported of the technique was performed.

Results: Six patients had a urinary tract reconstruction with the DBWC technique, 5 male patients and one female patient. Age range was from 20 to 77 years, with a medium age 53.6 years. The most frequent complication presented was a pelvic abscess in 3 patients (42.85%); all complications could be resolved with a conservative treatment.

Conclusion: In the group of our patients with pelvic exenteration and urinary tract reconstruction with a DBWC, it is a safe procedure and well tolerated by the patients, and most of the complications can be resolved with conservative treatment.

Show MeSH
Related in: MedlinePlus