Use of an ureteroileocecal appendicostomy urinary reservoir in patients with recurrent pelvic malignancies treated with radiation Journal Article
| Authors: | Bochner, B. H.; McCreath, W. A.; Aubey, J. J.; Levine, D. A.; Barakat, R. R.; Abu Rustum, N.; Poynor, E.; Wong, D.; Chi, D. S. |
| Article Title: | Use of an ureteroileocecal appendicostomy urinary reservoir in patients with recurrent pelvic malignancies treated with radiation |
| Abstract: | Objective. Evaluation of a modified right colon urinary reservoir in a heavily radiated patient population undergoing pelvic exenteration. Methods. A retrospective chart review was performed on all patients with recurrent gynecologic, colorectal, and urological tumors who underwent total pelvic or anterior exenteration and urinary diversion from 3/01 to 7/03 using an ureteroileocecal appendicostomy urinary reservoir. Results. Fourteen patients were identified over the study interval. The mean age of the patients was 53 years (range, 22-78 years). All patients received external beam, intracavitary, or a combination of both radiation treatment modalities to the pelvis preoperatively. Eight patients received intraoperative radiation therapy (IORT) at a mean dose of 16.25 Gy (range, 12.5-17.5 Gy). The primary sites of disease were as follows: cervix, five; prostate, three; uterus, two; colon/rectum two; and one each for vulva and bladder. Complete stomal continence was achieved in all patients after a median follow-up of 10 months (range, 2-31 months). Two patients experienced a traumatic disruption of the stomal-skin anastomosis in the early postoperative period (postoperative days 7 and 14). One late complication related to the ureterointestinal anastomosis was observed and consisted of an anastomotic stricture managed conservatively. One patient experienced an entero-pouch fistula following re-exploration for an acute postoperative hemorrhage. Conclusion. The early outcomes using the ureteroileocecal appendicostomy urinary reservoir in heavily radiated patients demonstrate the technical feasibility of this design as both minimal early stoma and ureterointestinal complications may occur. Longer postoperative follow-up will be required to address the late outcomes of this procedure and its ultimate use in this population. © 2004 Elsevier Inc. All rights reserved. |
| Keywords: | adult; clinical article; controlled study; aged; middle aged; retrospective studies; review; cancer localization; postoperative period; fistula; cancer patient; cancer radiotherapy; preoperative care; radiation dose; combined modality therapy; recurrent cancer; follow up; creatinine; retrospective study; bladder cancer; prostate cancer; postoperative complication; colorectal tumor; population; uterine cervix cancer; stoma; urinary diversion; medical record; pelvis exenteration; appendix; cecostomy; pelvic neoplasms; urinary reservoirs, continent; urinary tract cancer; catheterization; outcomes research; ureter; postoperative hemorrhage; anastomosis; pelvis cancer; peroperative care; ileum; acute disease; clinical observation; anastomosis, surgical; vulva cancer; pelvic exenteration; acidosis; pelvic radiation; humans; human; male; female; priority journal; urinary tract reconstruction; ureteroileocecal appendicostomy urinary reservoir |
| Journal Title: | Gynecologic Oncology |
| Volume: | 94 |
| Issue: | 1 |
| ISSN: | 0090-8258 |
| Publisher: | Elsevier Inc. |
| Date Published: | 2004-07-01 |
| Start Page: | 140 |
| End Page: | 146 |
| Language: | English |
| DOI: | 10.1016/j.ygyno.2004.03.031 |
| PROVIDER: | scopus |
| PUBMED: | 15262132 |
| DOI/URL: | |
| Notes: | Gynecol. Oncol. -- Cited By (since 1996):11 -- Export Date: 16 June 2014 -- CODEN: GYNOA -- Source: Scopus |
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