The colon shuffle: A modified urinary diversion.

Area of Science:

• Urology
• Surgical Oncology
• Gastroenterology

Background:

• Urinary diversion is often necessary in patients undergoing colorectal surgery.
• Existing colostomies or the need for concurrent colon resection complicate urinary diversion.
• The 'colon shuffle' is a novel technique developed at our institute.

Purpose of the Study:

• To evaluate the outcomes of the colon shuffle procedure.
• To assess its efficacy in patients requiring simultaneous colostomy or with pre-existing colostomies.
• To analyze complication rates in this high-risk patient cohort.

Main Methods:

• A retrospective review of patients who underwent the colon shuffle between 2003 and 2013.
• Assessment of patient comorbidity using the Charlson comorbidity index.
• Documentation of prior treatments (radiotherapy, chemotherapy) and surgical complications (Clavien-Dindo classification).

Main Results:

• Twenty-one patients (mean age 61.5 years) underwent the colon shuffle.
• 90.4% of patients had prior pelvic radiotherapy.
• 52.4% experienced short-term complications, but no major anastomotic leakage or fecal peritonitis occurred.

Conclusions:

• The colon shuffle is an elegant and effective solution for urinary diversion in complex colorectal cases.
• It is particularly beneficial for patients with existing colostomies or those requiring simultaneous colostomy creation.
• The procedure demonstrates a favorable safety profile, even in high-risk patients previously treated with radiotherapy.