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629 10 Years of double-barrel wet colostomy: a single-institution’s experience performing an alternative diversion in patients undergoing total pelvic exenteration for gynecologic malignancy
  1. Maureen Byrne,
  2. Mario M Leitao,
  3. Nadeem R Abu-Rustum,
  4. Yukio Sonoda and
  5. Vance Broach
  1. Gynecology Service, Memorial Sloan Kettering Cancer Center, New York, USA

Abstract

Introduction/Background Double-barrel wet colostomy (DBWC) is an alternative diversion for patients undergoing total pelvic exenteration (TPE), which avoids bowel reanastomosis and leaves patients with one ostomy instead of two. We sought to compare operative characteristics and short- and long-term complication rates between patients who had a DBWC versus those who received separate urinary and bowel (SUB) diversions during TPE for gynecologic malignancy.

Methodology We performed a retrospective study of all patients who underwent TPE for gynecologic cancer at our institution from 3/1/2013 to 3/1/2023. Patient demographics, clinical and surgical data, as well as information on short- and long-term complications were collected. Appropriate statistical tests were employed.

Results A total of 60 TPEs were performed at our institution during the study period. Twenty-eight patients (47%) underwent DBWC and 32 (53%) underwent SUB. No differences were found between groups for patient age, race, BMI, hypertension, diabetes, or previous radiation. Estimated blood loss and length of hospital stay did not differ between groups. The median operative time was significantly shorter for patients with DBWC (491min, range=349–759) when compared to patients with SUB (556 min, range=331–855), (p=0.02). There were no differences in rates of readmission or complications between the two groups either in the immediate postoperative period (<30d) or long-term period (> 30 days). When complications were subcategorized by stomal-related complications (including stomal necrosis, peristomal skin breakdown, and stomal hernia), urinary complications (including pyelonephritis, hydronephrosis, and acute kidney injury), or infectious complications (including sepsis, intra-abdominal abscess, and surgical site infection), there were no differences between groups.

Conclusion In patients undergoing total pelvic exenteration for gynecologic malignancy, creation of a DBWC led to a shorter operative time compared to SUB. DBWC demonstrated similar rates of readmissions and both short- and long-term complications when compared to SUB and should be considered an acceptable alternative to traditional SUB diversion.

Disclosures None.

Abstract 629 Table 1

Patient characteristics and postoperative outcomes for DBWC and SUB

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