Introduction/Background Pelvic exenteration is performed in patients who suffer from relapsed gynaecologic tumours, with most of them requiring some sort of urinary diversion.
Methodology The main objective of this study was to assess the urinary complications associated with the Bricker ileal conduit versus double-barrelled wet colostomy after performing a pelvic exenteration for gynaecologic malignancies.
Results A total of 61 pelvic exenterations were identified between November 2010 and April 2022; 29 Bricker ileal conduits and 20 double-barrelled wet colostomies were included in the urinary diversion analysis. Regarding the specific short-term urinary complications, no differences were found in the rate of urinary leakage (3 vs 0%; p = 1), urostomy complications (7 vs 0%; p = 0.51), acute renal failure (10 vs 20%; p = 0.24) or urinary infection (0 vs 5%; p = 0.41). Up to 69% of patients with Bricker ileal conduits and 65% of double-barrelled wet colostomies (p = 0.76) presented specific medium/long-term urinary complications. No differences in the rates of pyelonephritis (59 vs 53%; p = 0.71), urinary fistula (0 vs 12%; p = 0.13), ureteral stricture (10 vs 6%; p = 1), conduit failure and reconstruction (7 vs 0%; p = 0.53), renal failure (38 vs 29%; p = 0.56) or electrolyte disorders (24 vs 18%; p = 0.72) were found. The OS (Overall survival) after pelvic exenteration at 12 and 48 months was 77% and 58%, respectively. The DFS (Disease Free Survival) at 12 and 48 months after pelvic exenteration was 64% and 51%, respectively.
Conclusion Between double-barrelled wet colostomy and the Bricker ileal conduit, the related urinary complications remained high regardless of the type of technique. In this context, the double-barrelled wet colostomy presents advantages such as the single stoma placement and the simplicity of the technique.
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