title: Ileal conduit and continent ileocecal pouch for patients undergoing pelvic exenteration: comparison of complications and quality of life.
abstract: OBJECTIVE
  Creating a continent urinary pouch has become an alternative to the ileal conduit for patients undergoing exenteration for advanced gynecologic malignancies. The objective of this study was to compare clinical outcomes for the 2 methods.
  
  
  METHODS
  In this retrospective study, we compared intraoperative and postoperative complications and quality-of-life scores for the modified ileocecal pouch and the ileal conduit in anterior or total pelvic exenteration.
  
  
  RESULTS
  In 33 of 100 patients, an ileal pouch (IP) was created; the other 67 were treated by an ileal conduit (IC). Creating an IP prolonged the exenterative procedure by 97 minutes compared to an IC (IC, 453 minutes vs IP, 550 minutes; P = 0.009). Overall complication rates were similar, but patients with an IP had significantly more complications of urinary diversion (48%) than patients with an IC (31%; P = 0.03). Follow-up showed urinary loss and frequency of micturition to be comparable, but in patients with an IP, surgery for stomal complications (n = 2) and treatment of bladderstones were necessary more frequently (n = 3). Quality of life according to the 12-item Short Form Health Survey questionnaire was similar in both groups.
  
  
  CONCLUSIONS
  A continent IP is an alternative to the IC in cases of pelvic exenteration. Early complications are more frequent with an IP than with an IC. The mode of urinary diversion has little influence on the quality of life in patients with advanced genital cancer.
authors.affiliation: Kaiserswerther Diakonie, Florence Nightingale Hospital, Duesseldorf, Germany. dr.forner@gmx.de
authors.forename: Dirk Michael
authors.initials: DM
authors.lastname: Forner
authors.forename: Björn
authors.initials: B
authors.lastname: Lampe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D039021:Colonic Pouches; D005260:Female; D005500:Follow-Up Studies; D005833:Genital Neoplasms, Female / Q000150:complications / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010385:Pelvic Exenteration; D011183:Postoperative Complications; D011788:Quality of Life; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D014547:Urinary Diversion; D016476:Urinary Reservoirs, Continent