Double-barreled colon conduit and colostomy for simultaneous urinary and fecal diversions: long-term follow-up

Ann Surg Oncol. 2014 Dec;21 Suppl 4:S522-7. doi: 10.1245/s10434-013-3478-4. Epub 2014 May 30.

Abstract

Background: Best strategies for simultaneous urinary and stool diversion remain indeterminate. Here we present what is to our knowledge the longest outcome data on double-barreled colon conduit and colostomy (DBCCC) in a cohort of patients needing simultaneous urinary and fecal diversion.

Methods: We identified 9 patients who underwent DBCCC between March 2002 and March 2013. Nine patients who underwent separate urinary and fecal diversion (colostomy plus percutaneous nephrostomy or ureterocutaneostomy) served as the control group. We compared demographics, comorbidities, follow-up morbidities, and European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30-item questionnaire in the two groups.

Results: The preservation of renal function was better in the DBCCC group. There were significant improvements in global state of health, fatigue, insomnia, appetite, bowel habit, and social function in the DBCCC group. In comparison with the separate urinary and fecal diversion group, the patients in the DBCCC group had statically significant improvement in global health status, functional scales, and symptom scales.

Conclusions: Compared with the separate urinary and fecal diversion technique, DBCCC provides preservation of renal function, easy stoma bag care, better quality of life, and improved body image for patients who need simultaneous urinary and fecal diversion.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Colorectal Neoplasms / surgery*
  • Colostomy / adverse effects
  • Colostomy / methods*
  • Female
  • Follow-Up Studies
  • Health Status
  • Humans
  • Kidney / physiology
  • Male
  • Middle Aged
  • Pelvic Exenteration
  • Pyelonephritis / etiology
  • Quality of Life*
  • Retrospective Studies
  • Time Factors
  • Urinary Bladder Neoplasms / surgery*
  • Urinary Diversion / adverse effects
  • Urinary Diversion / methods*
  • Uterine Cervical Neoplasms / surgery*