title: [Urinary diversion in patients treated with pelvic irradiation: transverse colon conduit revisited].
abstract: In patients receiving pelvic irradiation for gynecological or genitourinary malignancies, urinary diversion is sometimes required for complete resection of malignancies or treatment of urological complications by irradiation. We report our attempts to promote healing and prevent complications by urinary diversion using a transverse colon conduit in cases in which urinary reconstruction was performed with irradiated lower abdominal organs such as small intestine or distal ureters. Between 2008 and 2012, 9 patients with pelvic irradiation received transverse colon conduit urinary diversion. Six patients received diversion for genitourinary complications, while 3 patients received complete resection of pelvic malignancies. Colostomy formation and lithotripsy of vesical stones were simultaneously performed in 4 cases. Wallace method was adopted for ureterointestinal anastomosis. There was no operative mortality. Although acute pyelonephritis, ileus, wound dehiscence and pelvic abscess formation were seen as postoperative complications, all but two improved without any additional procedure. Cases of pelvic abscess or wound dehiscence were treated by abscess drainage. In observation periods, no patients required urinary stent placement and none suffered from defecation problems. We think that transverse colon conduit can be a viable option for patients with pelvic irradiation history, affording them reasonable quality of life postoperatively.
authors.affiliation: The Department of Urology, Kyoto University Graduate School of Medicine.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Matsui
authors.affiliation: The Department of Urology, Hyogo Collage of Medicine.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Kanematsu
authors.affiliation: The Department of Urology, Kyoto University Graduate School of Medicine.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Negoro
authors.affiliation: The Department of Urology, Kyoto University Graduate School of Medicine.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: The Department of Urology, Kyoto University Graduate School of Medicine.
authors.forename: Naoki
authors.initials: N
authors.lastname: Terada
authors.affiliation: The Department of Urology, Kyoto University Graduate School of Medicine.
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Sugino
authors.affiliation: The Department of Urology, Kyoto University Graduate School of Medicine.
authors.forename: Toshinari
authors.initials: T
authors.lastname: Yamasaki
authors.affiliation: The Department of Urology, Kyoto University Graduate School of Medicine.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Inoue
authors.affiliation: The Department of Urology, Kyoto University Graduate School of Medicine.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Kamba
authors.affiliation: The Department of Urology, Kyoto University Graduate School of Medicine.
authors.forename: Koji
authors.initials: K
authors.lastname: Yoshimura
authors.affiliation: The Department of Urology, Kyoto University Graduate School of Medicine.
authors.forename: Osamu
authors.initials: O
authors.lastname: Ogawa
mesh_terms: D000328:Adult; D000368:Aged; D044684:Colon, Transverse / Q000528:radiation effects / Q000601:surgery*; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010388:Pelvis / Q000528:radiation effects*; D011471:Prostatic Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D011878:Radiotherapy / Q000009:adverse effects; D001749:Urinary Bladder Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D014594:Uterine Neoplasms / Q000532:radiotherapy / Q000601:surgery*