Pavlov M J, Ceranic M S, Nale D P, Latincic S M, Kecmanovic D M
School of Medicine, University of Belgrade, Belgrade, Serbia Department for Colorectal and Pelvic Surgery, First Surgical Clinic, Clinical Center of Serbia, Belgrade, Serbia.
School of Medicine, University of Belgrade, Belgrade, Serbia IV department, Clinic of Urology, Clinical Center of Serbia, Belgrade, Serbia.
Scand J Surg. 2014 Sep;103(3):189-194. doi: 10.1177/1457496913509982. Epub 2014 Feb 11.
The aim of this study was to compare the feasibility and early postoperative outcomes between patients undergoing double-barreled wet colostomy and patients undergoing terminal colostomy and ileal conduit for simultaneous urinary and fecal diversion.
Between 1995 and 2012, we had 181 patients in whom it was necessary to make simultaneous urinary and fecal diversion. This is a retrospective study and patients were divided into two groups, depending on the technique applied for the fecal and urinary diversion. The first group consisted of patients undergoing ileal conduit and terminal colostomy and the second group consisted of patients undergoing double-barreled wet colostomy.
Ileal conduit and terminal colostomy was performed in 77 (43%) cases, while wet colostomy was performed in 104 (57%) cases. Median length of stay was shorter for double-barreled wet colostomy (13.1 vs 18.1, p < 0.0001). Median operating times for urinary and fecal diversion were shorter for double-barreled wet colostomy (32 vs 64 min, p < 0.0001). The morbidity was lower for double-barreled wet colostomy (11.5% vs 23.4%, p = 0.0432), retrospectively. The mortality was 3.8% for double-barreled wet colostomy and 10.3% for ileal conduit and terminal colostomy group (p = 0.1282).
Double-barreled wet colostomy is a safe, fast, and simple alternative to traditional ileal conduit and terminal colostomy diversion. The technique is relatively easy to learn, and it reduces the time for urinary and fecal diversion, length of stay, and morbidity rate.
本研究旨在比较接受双腔湿结肠造口术的患者与接受末端结肠造口术和回肠膀胱术以同时进行尿液和粪便改道的患者之间的可行性和术后早期结局。
1995年至2012年期间，我们有181例患者需要同时进行尿液和粪便改道。这是一项回顾性研究，根据用于粪便和尿液改道的技术将患者分为两组。第一组由接受回肠膀胱术和末端结肠造口术的患者组成，第二组由接受双腔湿结肠造口术的患者组成。
77例（43%）患者接受了回肠膀胱术和末端结肠造口术，104例（57%）患者接受了双腔湿结肠造口术。双腔湿结肠造口术的中位住院时间较短（13.1天对18.1天，p<0.0001）。双腔湿结肠造口术的尿液和粪便改道中位手术时间较短（32分钟对64分钟，p<0.0001）。回顾性分析显示，双腔湿结肠造口术的发病率较低（11.5%对23.4%，p=0.0432）。双腔湿结肠造口术的死亡率为3.8%，回肠膀胱术和末端结肠造口术组的死亡率为10.3%（p=0.1282）。
双腔湿结肠造口术是传统回肠膀胱术和末端结肠造口术改道的一种安全、快速且简单的替代方法。该技术相对容易学习，并且减少了尿液和粪便改道时间、住院时间以及发病率。
