Department of Surgery, the Ohio State University Medical Center, Columbus, OH, USA.
Urology. 2011 Oct;78(4):856-62. doi: 10.1016/j.urology.2011.06.030. Epub 2011 Aug 31.
To compare outcomes and feasibility of double-barreled wet colostomy and ileal conduit (IC) in patients undergoing total pelvic exenteration (TPE).
Between 2004 and 2010, 54 patients underwent TPE for pelvic malignancies. Of those patients, 53 had complete records available for analysis. Two groups were identified based on the technique used for urinary diversion, either by way of an IC or a double-barreled wet colostomy (DBWC). Demographics, comorbidities, complications, length of stay, operative times, morbidity, and mortality were compared between the 2 groups.
Forty-three patients (81%) underwent a DBWC and ten patients (19%) underwent an IC. The 2 groups were similar in terms of age, gender, and comorbidities. Eighteen patients underwent an R0 resection (39%) and twenty-eight (61%) patients had a non-R0 resection. Seven patients (13%) had a complete response to therapy with no evidence of malignancy. A majority of the patients (68%) undergoing TPE had colorectal histology. Thirty-day morbidity directly related to complications of urinary or fecal diversion was 78% in the DBWC group and 58% in the IC group. There was no perioperative mortality in either group.
DBWC is a safe and feasible alternative to the traditional IC for urinary diversion. This technique is easy to learn and is associated with similar operative times, length of stay, morbidity, and mortality compared with IC.
比较全盆腔脏器切除术（TPE）患者中双套管式湿造口术与回肠造口术（IC）的结局和可行性。
2004 年至 2010 年间，54 例盆腔恶性肿瘤患者接受了 TPE。其中，53 例患者的完整记录可供分析。根据尿路转流术的方法，将患者分为两组，即采用 IC 或双套管式湿造口术（DBWC）。比较两组患者的人口统计学、合并症、并发症、住院时间、手术时间、发病率和死亡率。
43 例（81%）患者行 DBWC，10 例（19%）患者行 IC。两组在年龄、性别和合并症方面相似。18 例患者行 R0 切除术（39%），28 例（61%）患者行非 R0 切除术。7 例患者（13%）经治疗后完全缓解，无恶性肿瘤证据。大多数（68%）接受 TPE 的患者的结直肠组织学类型。DBWC 组与 IC 组因尿路或粪便转流相关并发症导致的 30 天发病率分别为 78%和 58%。两组均无围手术期死亡。
DBWC 是传统 IC 尿路转流的安全可行替代方法。与 IC 相比，该技术易于学习，且手术时间、住院时间、发病率和死亡率相似。
