Double-barreled wet colostomy is a safe option for simultaneous urinary and fecal diversion. Analysis of 56 procedures from a single institution.
OBJECTIVE
Wide pelvic tumors need urinary and fecal diversion. We set out to assess the efficacy of the double-barreled wet colostomy (DBWC) in patients undergoing simultaneous double diversion.


METHODS
We reviewed 56 consecutive patients submitted to surgery, divided into two groups: (1) total pelvic exenteration plus DBWC (n = 26); (2) DBWC without simultaneous pelvic resection (n = 30). Pelvic tumor recurrences accounted for most patients (n = 53), whereas the remaining three patients suffered from actinic pelvic complications.


RESULTS
Surgical morbidity and mortality rates were 53.8% (14/26) and 11.5% (3/26) in Group 1, and 43.5% (13/30) and 3.3% (1/30) in Group 2, respectively. Only 2 patients out of 51 (3.9%) developed late postoperative urinary tract infection. Regression of the hydronephrosis was observed in 28 out of 33 assessable patients. Median survival in Groups 1 and 2 was 8.36 and 4.14 months, respectively. In the subgroup of patients submitted to curative surgery (n = 24), actuarial cancer-specific survival rate in 2 years was 58.78%.


CONCLUSIONS
DBWC is a safe and efficient alternative for simultaneous urinary and fecal diversion, with low morbidity and mortality rates, improvement of renal insufficiency, and low risk of postoperative urinary tract infection.
Departamento de Cirurgia Pélvica, Hospital do Câncer A.C.Camargo, Rua Professor Antonio Prudente, São Paulo, Brazil. guimaraesgc@uol.com.br
Gustavo C
GC
Guimaraes
Fabio O
FO
Ferreira
Benedito M
BM
Rossi
Samuel
S
Aguiar
Stenio C
SC
Zequi
Wilson
W
Bachega
Wilson T
WT
Nakagawa
Francisco P
FP
Fonseca
Alvaro S
AS
Sarkis
Ademar
A
Lopes
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003125:Colostomy / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D010385:Pelvic Exenteration; D010386:Pelvic Neoplasms / Q000601:surgery*; D011183:Postoperative Complications; D014547:Urinary Diversion / Q000379:methods*