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.
Guimaraes
Gustavo C
GC
Departamento de Cirurgia Pélvica, Hospital do Câncer A.C.Camargo, Rua Professor Antonio Prudente, São Paulo, Brazil. guimaraesgc@uol.com.br
Ferreira
Fabio O
FO
Rossi
Benedito M
BM
Aguiar
Samuel
S
Zequi
Stenio C
SC
Bachega
Wilson
W
Nakagawa
Wilson T
WT
Fonseca
Francisco P
FP
Sarkis
Alvaro S
AS
Lopes
Ademar
A
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*