Supralevator pelvic exenteration with colonic J-pouch-anal anastomosis and Mainz pouch operation with anastomosis to the urethra. Report of a case.
This is the first documented case report in which construction of double pouches, a colonic J-pouch and a Mainz pouch with anastomosis to the urethra, was performed in a patient who underwent supralevator pelvic exenteration. We have shown that the operation is feasible; the patient was continent, except for nightly urinary leakage, and was able to defecate and urinate spontaneously without any catheterization. Based on the experience of this case, we believe that this combined operation results in a better quality of life for the patient because of the avoidance of both urinary and fecal stomas. If justified pathologically, this operation may represent an improvement for those patients with extensive cancer of the rectum, which invades the adjacent anterior viscera, or that of the bladder, which invades the posterior viscera.
Hatakeyama
K
K
Department of Surgery, Niigata University School of Medicine, Japan.
Muto
T
T
Nishiyama
T
T
Washiyama
K
K
D000328:Adult; D000714:Anastomosis, Surgical; D006801:Humans; D008297:Male; D010385:Pelvic Exenteration / Q000379:methods*; D016737:Proctocolectomy, Restorative / Q000379:methods*; D012004:Rectal Neoplasms / Q000556:secondary / Q000601:surgery*; D014521:Urethra / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000556:secondary / Q000601:surgery*; D016476:Urinary Reservoirs, Continent / Q000379:methods*