title: The colon shuffle: A modified urinary diversion.
abstract: OBJECTIVE
  To assess the results of a urinary diversion in patients who already have a colostomy or simultaneously require a (rectum) colon resection. The diversion is created from the distal part of the transected colon with a simultaneously created new colostomy contra-laterally (if necessary). This procedure is known in our institute as the 'colon shuffle'.
  
  
  METHODS
  All patients who underwent a colon shuffle in the period of 2003 and 2013 in our institute (Netherlands Cancer Institute-Antoni van Leeuwenhoek Hospital) were identified. Comorbidity was scored using the Charlson comorbidity index. Local or systemic treatment prior to surgery was reported (e.g. external beam radiotherapy, systemic chemotherapy). Surgical complications were reported according to the Clavien-Dindo classification.
  
  
  RESULTS
  Twenty-one patients (14 male; 7 female) underwent a colon shuffle procedure in our institute, with a mean age of 61.5 years. The majority (90.4%) of these patients had been subjected to radiotherapy on the pelvic region in the past. Although short-term complications (<30 days) were seen in 52.4% of these patients, major complications such as anastomotic leakage of the bowel and fecal peritonitis were not seen in this high-risk group of patients.
  
  
  CONCLUSIONS
  The colon shuffle offers an elegant solution for patients who require a urinary diversion simultaneously with a colostomy or for patients who already have a colostomy from previous surgery.
authors.affiliation: Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Urology, University Medical Center Utrecht, The Netherlands. Electronic address: rpmeijer111@yahoo.com.
authors.forename: R P
authors.initials: RP
authors.lastname: Meijer
authors.affiliation: Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: L S
authors.initials: LS
authors.lastname: Mertens
authors.affiliation: Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: W
authors.initials: W
authors.lastname: Meinhardt
authors.affiliation: Department of Surgery, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: V J
authors.initials: VJ
authors.lastname: Verwaal
authors.affiliation: Department of Pediatric Urology, University Medical Center Utrecht, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Dik
authors.affiliation: Department of Urology, The Netherlands Cancer Institute, Amsterdam, The Netherlands.
authors.forename: S
authors.initials: S
authors.lastname: Horenblas
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003106:Colon / Q000637:transplantation*; D003108:Colonic Diseases / Q000601:surgery*; D003125:Colostomy / Q000379:methods*; D015653:Cystectomy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010385:Pelvic Exenteration / Q000379:methods; D012002:Rectal Diseases / Q000601:surgery*; D012189:Retrospective Studies; D014547:Urinary Diversion / Q000379:methods*; D014570:Urologic Diseases / Q000601:surgery*
keywords: Bladder substitution; Colon conduit; Pelvic exenteration; Urinary diversion