Video-assisted double-barreled wet colostomy: a new minimally invasive simultaneous diversion to patients after pelvic radiation therapy.
BACKGROUND
A wet colostomy can be done when the simultaneous diversion of fecal and urine streams are necessary. Laparoscopic access is gaining space in urinary diversion procedures. The aim of the present study was to present the technique and results of the first case reported of a video-assisted double-barreled wet colostomy.


METHODS
In this article, we report a case of a 50-year-old woman with actinic complex urinary and fecal fistula, treated through a retroperitoneoscopic double-barreled wet colostomy. Only the left kidney had function, so she was treated by video endoscopic retroperitoneal dissection of the left ureter, preplanned transverse 5-cm incision for exteriorization of left colon and ureter, extracorporeal section of the left colon with a linear stapler, extracorporeal antireflux ureterocolonic anastomosis, and maturation of the stoma 10 cm proximal to the end of the proximal colonic loop.


RESULTS
Operative time was 135 minutes. No transfusion was required nor had intraoperative complications occurred. Oral intake was initiated in postoperative day 2, and the patient was discharged postoperative day 6 without complications. Normal activities were recovered after 21 days. In a 3-month follow-up, there were no infectious complications, and good urinary drainage was observed. She was satisfied and adapted to the stoma.


CONCLUSIONS
Video-assisted double-barreled wet colostomy is a feasible procedure. The same goals of the open procedure were achieved, offering the advantages of the laparoscopic approach.
Tobias-Machado
Marcos
M
Section of Urologic Oncology, Department of Urology, ABC Medical School and Brazilian Institute of Cancer Control, São Paulo, Brazil. tobias-machado@uol.com.br
Bicudo
Maria C
MC
Appolonio
Paulo R
PR
Korkes
Fernando
F
Starling
Eduardo S
ES
Pompeu
Antonio C L
AC
Wroclawski
Eric R
ER
D002277:Carcinoma / Q000473:pathology / Q000628:therapy; D003125:Colostomy / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy; D008875:Middle Aged; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012006:Rectovaginal Fistula / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D025321:Surgery, Computer-Assisted; D014547:Urinary Diversion / Q000379:methods*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000628:therapy; D014719:Vesicovaginal Fistula / Q000209:etiology / Q000473:pathology / Q000601:surgery*