The double-barreled wet ileostomy: an alternative method for simultaneous urinary and intestinal diversion without intestinal anastomosis after total colectomy and pelvic exenteration.
BACKGROUND
Although the number of cases of locally advanced colorectal cancer related to familial adenomatous polyposis (FAP) has decreased as a result of a better understanding of the disease, the condition still can offer therapeutic challenges.


METHODS
We report a case of a rectal tumor with prostate invasion associated with FAP, treated with neoadjuvant radiotherapy and total extended proctocolectomy with cystoprostatectomy. The reconstruction was undertaken with a double-barreled ileostomy with ureteral reimplantation on the distal segment of the ileostomy. Data including surgical aspects, post-operative complications, and outcome were evaluated.


CONCLUSIONS
The double-barreled wet ileostomy is a technically straightforward and safe procedure that is easily executed and may be an alternative to simultaneous diversion in extreme situations. To the best of our knowledge, this is the first description of this procedure in the literature.
Guimarães
Gustavo Cardoso
GC
Pelvic Surgery Department, Hospital do Câncer A. C. Camargo, Fundação Antônio Prudente, Sao Paulo, Brazil. guimaraesgc@uol.com.br
Terabe
Fabio
F
Rossi
Benedito Mauro
BM
Aguiar Júnior
Samuel
S
Ferreira
Fabio de Oliveira
Fde O
Nakagawa
Wilson Toshihiko
WT
Lopes
Ademar
A
D000230:Adenocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D000713:Anastomosis, Roux-en-Y; D003082:Colectomy / Q000379:methods*; D003110:Colonic Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000628:therapy*; D003113:Colonoscopy; D005500:Follow-Up Studies; D006801:Humans; D007081:Ileostomy / Q000379:methods; D007421:Intestine, Small / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000556:secondary / Q000601:surgery; D018714:Radiotherapy, Adjuvant; D012086:Reoperation; D014057:Tomography, X-Ray Computed; D014547:Urinary Diversion / Q000379:methods*