Jesse P. Wright , Whitney M. Guerrero , Jonathan R. Lucking , Leonardo Bustamante-Lopez , John R.T. Monson
{"title":"双桶湿式结肠造口术:盆腔切除后尿分流的一种替代方法","authors":"Jesse P. Wright , Whitney M. Guerrero , Jonathan R. Lucking , Leonardo Bustamante-Lopez , John R.T. Monson","doi":"10.1016/j.surge.2023.03.004","DOIUrl":null,"url":null,"abstract":"<div><h3>Aim</h3><p><span><span>Pelvic exenteration is a radical procedure used to treat locally advanced and/or recurrent pelvic </span>malignancies<span><span>. Different reconstruction options exist, the most popular being the end colostomy with </span>ileal conduit<span><span>. The double barrel wet colostomy (DBWC) offers concomitant fecal and urinary diversion through a single stoma, but is infrequently utilized. We aim to review the evidence base of the </span>postoperative complications, long-term oncologic risks and </span></span></span>quality of life following creation of a double barrel wet colostomy.</p></div><div><h3>Methods</h3><p>A narrative review of the literature was performed evaluating the DBWC. Patient demographics, perioperative complications, operative variables, long terms oncologic outcomes and quality of life data were extracted. Descriptive statistics were used to define the data.</p></div><div><h3>Results</h3><p>Fourteen articles with a total of 300 patients undergoing DBWC following pelvic exenteration were selected. 41% of malignancies were gastrointestinal in origin while 41.7% were gynecologic and 5.3% genitourinary. 42% of patients experienced at least one complication within in 40 days of surgery, the most common being wound infection (8.7%) and urinary leak (8.3%). There was no evidence of malignancy within the DBWC during long-term surveillance. Quality of life following DBWC is comparable to other reconstructive methods.</p></div><div><h3>Conclusion</h3><p>The DBWC is a well described reconstructive method for urinary and fecal diversion utilizing a single stoma following pelvic exenteration. The short- and long-term outcomes following DBWC are comparable to other reconstructive methods and the quality of life with a DBWC is acceptable. DBWC should remain a readily available option for reconstruction following pelvic exenteration.</p></div>","PeriodicalId":49463,"journal":{"name":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","volume":null,"pages":null},"PeriodicalIF":2.3000,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The double-barrel wet colostomy: An alternative for urinary diversion after pelvic exenteration\",\"authors\":\"Jesse P. Wright , Whitney M. Guerrero , Jonathan R. Lucking , Leonardo Bustamante-Lopez , John R.T. Monson\",\"doi\":\"10.1016/j.surge.2023.03.004\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Aim</h3><p><span><span>Pelvic exenteration is a radical procedure used to treat locally advanced and/or recurrent pelvic </span>malignancies<span><span>. Different reconstruction options exist, the most popular being the end colostomy with </span>ileal conduit<span><span>. The double barrel wet colostomy (DBWC) offers concomitant fecal and urinary diversion through a single stoma, but is infrequently utilized. We aim to review the evidence base of the </span>postoperative complications, long-term oncologic risks and </span></span></span>quality of life following creation of a double barrel wet colostomy.</p></div><div><h3>Methods</h3><p>A narrative review of the literature was performed evaluating the DBWC. Patient demographics, perioperative complications, operative variables, long terms oncologic outcomes and quality of life data were extracted. Descriptive statistics were used to define the data.</p></div><div><h3>Results</h3><p>Fourteen articles with a total of 300 patients undergoing DBWC following pelvic exenteration were selected. 41% of malignancies were gastrointestinal in origin while 41.7% were gynecologic and 5.3% genitourinary. 42% of patients experienced at least one complication within in 40 days of surgery, the most common being wound infection (8.7%) and urinary leak (8.3%). There was no evidence of malignancy within the DBWC during long-term surveillance. Quality of life following DBWC is comparable to other reconstructive methods.</p></div><div><h3>Conclusion</h3><p>The DBWC is a well described reconstructive method for urinary and fecal diversion utilizing a single stoma following pelvic exenteration. The short- and long-term outcomes following DBWC are comparable to other reconstructive methods and the quality of life with a DBWC is acceptable. DBWC should remain a readily available option for reconstruction following pelvic exenteration.</p></div>\",\"PeriodicalId\":49463,\"journal\":{\"name\":\"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2023-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1479666X23000409\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Surgeon-Journal of the Royal Colleges of Surgeons of Edinburgh and Ireland","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1479666X23000409","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
The double-barrel wet colostomy: An alternative for urinary diversion after pelvic exenteration
Aim
Pelvic exenteration is a radical procedure used to treat locally advanced and/or recurrent pelvic malignancies. Different reconstruction options exist, the most popular being the end colostomy with ileal conduit. The double barrel wet colostomy (DBWC) offers concomitant fecal and urinary diversion through a single stoma, but is infrequently utilized. We aim to review the evidence base of the postoperative complications, long-term oncologic risks and quality of life following creation of a double barrel wet colostomy.
Methods
A narrative review of the literature was performed evaluating the DBWC. Patient demographics, perioperative complications, operative variables, long terms oncologic outcomes and quality of life data were extracted. Descriptive statistics were used to define the data.
Results
Fourteen articles with a total of 300 patients undergoing DBWC following pelvic exenteration were selected. 41% of malignancies were gastrointestinal in origin while 41.7% were gynecologic and 5.3% genitourinary. 42% of patients experienced at least one complication within in 40 days of surgery, the most common being wound infection (8.7%) and urinary leak (8.3%). There was no evidence of malignancy within the DBWC during long-term surveillance. Quality of life following DBWC is comparable to other reconstructive methods.
Conclusion
The DBWC is a well described reconstructive method for urinary and fecal diversion utilizing a single stoma following pelvic exenteration. The short- and long-term outcomes following DBWC are comparable to other reconstructive methods and the quality of life with a DBWC is acceptable. DBWC should remain a readily available option for reconstruction following pelvic exenteration.
期刊介绍:
Since its establishment in 2003, The Surgeon has established itself as one of the leading multidisciplinary surgical titles, both in print and online. The Surgeon is published for the worldwide surgical and dental communities. The goal of the Journal is to achieve wider national and international recognition, through a commitment to excellence in original research. In addition, both Colleges see the Journal as an important educational service, and consequently there is a particular focus on post-graduate development. Much of our educational role will continue to be achieved through publishing expanded review articles by leaders in their field.
Articles in related areas to surgery and dentistry, such as healthcare management and education, are also welcomed. We aim to educate, entertain, give insight into new surgical techniques and technology, and provide a forum for debate and discussion.