Concurrent urinary and bowel diversion: Surgical modification with sigmoid colon that avoids a bowel anastomosis
Int. braz. j. urol; 46 (1), 2020
Publication year: 2020
ABSTRACT Objective:
Cystectomy with urinary diversion is the gold standard for muscle invasive bladder cancer. It also may be performed as part of pelvic exenteration for non-urologic malignancy, neurogenic bladder dysfunction, and chronic conditions that result in a non-functional bladder (e.g., interstitial cystitis, radiation cystitis). Our objective is to describe the surgical technique of urinary diversion using large intestine as a conduit whilst creating an end colostomy, thereby avoiding a primary bowel anastomosis and to show its applicability with respect to urologic conditions.Materials and Methods:
We retrospectively reviewed five cases from a single institution that utilized the described method of urinary diversion with large intestine. We describe operative times, hospital length of stay (LOS), and describe post-operative complications.Results:
Five patients with a variety of urologic and oncologic pathology underwent the described procedures. Their operative times ranged from 5 hours to 11 hours and one patient experienced a Clavien III complication.Conclusion:
We describe five patients who underwent this procedure for various medical indications, and describe their outcomes, and believe dual diversion of urinary and gastrointestinal systems with colon as a urinary conduit to be an excellent surgical option for the appropriate surgical candidate.
Anastomosis Quirúrgica, Colon Sigmoide/cirugía, Colostomía/métodos, Cistectomía/métodos, Tiempo de Internación, Ilustración Médica, Persona de Mediana Edad, Tempo Operativo, Reproducibilidad de los Resultados, Resultado del Tratamiento, Enfermedades de la Vejiga Urinaria/cirugía, Derivación Urinaria/métodos