Abstract
Background. Pelvic exenteration and multivisceral resection in colorectal have been described as a curative and palliative intervention. Urinary tract reconstruction in a pelvic exenteration is achieved in most cases with an ileal conduit of Bricker, although different urinary reservoirs have been described. Methods. A retrospective and observational study of six patients who underwent a pelvic exenteration and urinary tract reconstruction with a double barreled wet colostomy (DBWC) was done, describing the preoperative diagnosis, the indication for the pelvic exenteration, the complications associated with the procedure, and the followup in a period of 5 years. A literature review of the case series reported of the technique was performed. Results. Six patients had a urinary tract reconstruction with the DBWC technique, 5 male patients and one female patient. Age range was from 20 to 77 years, with a medium age 53.6 years. The most frequent complication presented was a pelvic abscess in 3 patients (42.85%); all complications could be resolved with a conservative treatment. Conclusion. In the group of our patients with pelvic exenteration and urinary tract reconstruction with a DBWC, it is a safe procedure and well tolerated by the patients, and most of the complications can be resolved with conservative treatment.
Highlights
Pelvic exenteration has been described since the 1940s as both a curative and palliative intervention in gynecologic cancer [1, 2]
Two of the patients were operated with a diagnosis of rectal adenocarcinoma, two patients with sigmoid colon adenocarcinoma, one patient with a neuroendocrine prostate tumor, and a patient with local recurrence of rectal adenocarcinoma, who previously had an abdominoperineal resection (APR) with in block hysterectomy 5 years prior to this intervention
The indication for pelvic exenteration was for locally advanced disease which infiltrated the urinary bladder and/or other bowel segments, a local recurrence, and, in one of the stage IV patients, a peritoneal implant was found in the pelvis
Summary
Pelvic exenteration has been described since the 1940s as both a curative and palliative intervention in gynecologic cancer [1, 2]. Pelvic exenteration and multivisceral resection in colorectal have been described as a curative and palliative intervention. A retrospective and observational study of six patients who underwent a pelvic exenteration and urinary tract reconstruction with a double barreled wet colostomy (DBWC) was done, describing the preoperative diagnosis, the indication for the pelvic exenteration, the complications associated with the procedure, and the followup in a period of 5 years. In the group of our patients with pelvic exenteration and urinary tract reconstruction with a DBWC, it is a safe procedure and well tolerated by the patients, and most of the complications can be resolved with conservative treatment
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