title: The double-barreled wet ileostomy: an alternative method for simultaneous urinary and intestinal diversion without intestinal anastomosis after total colectomy and pelvic exenteration.
abstract: 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.
authors.affiliation: Pelvic Surgery Department, Hospital do Câncer A. C. Camargo, Fundação Antônio Prudente, Sao Paulo, Brazil. guimaraesgc@uol.com.br
authors.forename: Gustavo Cardoso
authors.initials: GC
authors.lastname: Guimarães
authors.forename: Fabio
authors.initials: F
authors.lastname: Terabe
authors.forename: Benedito Mauro
authors.initials: BM
authors.lastname: Rossi
authors.forename: Samuel
authors.initials: S
authors.lastname: Aguiar Júnior
authors.forename: Fabio de Oliveira
authors.initials: Fde O
authors.lastname: Ferreira
authors.forename: Wilson Toshihiko
authors.initials: WT
authors.lastname: Nakagawa
authors.forename: Ademar
authors.initials: A
authors.lastname: Lopes
mesh_terms: 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*