title: Urinary diversion in patients undergoing pelvic exenteration.
abstract: Between October, 1969, and April, 1981, gynecologic oncologists at the University of Alabama Medical Center in Birmingham have performed 119 pelvic exenterations. One hundred fifteen of these patients had a concurrent supravesical urinary diversion. Fifty-six patients (48.7%) had an anterior exenteration and 59 patients (51.3%) had a total exenteration. An ileal segment was used as a conduit in 97 patients while the segment of transverse colon was used in 16 patients. Two patients had sigmoid conduits. Eighty-five patients (73.9%) had the intestinal anastomosis and conduit constructed with gastrointestinal staplers. Stapler use shortened the mean operating time for the exenterative procedure by approximately 30%. No increase in postoperative gastrointestinal complications was noted. Urinary diversion preformed as part of a pelvic exenteration has been associated with short- and long-term complications. The use of ureteral stents and the gastrointestinal staplers shortens the procedure without predisposing the patient to major urologic complications. The use of a segment of unirradiated bowel (transverse colon) in conjunction with these techniques constitutes the preferred method of supravesical urinary diversion in patients undergoing a pelvic exenteration.
mesh_terms: D003106:Colon / Q000601:surgery; D012809:Colon, Sigmoid / Q000601:surgery; D005260:Female; D006801:Humans; D007082:Ileum / Q000601:surgery; D008875:Middle Aged; D010385:Pelvic Exenteration / Q000009:adverse effects; D011183:Postoperative Complications / Q000209:etiology; D011552:Pseudomonas Infections / Q000209:etiology / Q000382:microbiology; D011704:Pyelonephritis / Q000209:etiology / Q000382:microbiology; D013528:Surgical Staplers; D014547:Urinary Diversion / Q000379:methods; D014548:Urinary Fistula / Q000209:etiology; D002583:Uterine Cervical Neoplasms / Q000601:surgery; D014594:Uterine Neoplasms / Q000601:surgery; D014625:Vaginal Neoplasms / Q000601:surgery; D014846:Vulvar Neoplasms / Q000601:surgery