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Related Experiment Videos

Urinary diversion in patients undergoing pelvic exenteration

J W Orr, H M Shingleton, K D Hatch

    American Journal of Obstetrics and Gynecology
    |April 1, 1982
    PubMed
    Summary

    Pelvic exenteration with supravesical urinary diversion is a complex gynecologic oncology procedure. Using gastrointestinal staplers and ureteral stents, along with transverse colon for diversion, shortens surgery time and avoids major complications.

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    Area of Science:

    • Gynecologic Oncology
    • Surgical Oncology
    • Urology

    Background:

    • Pelvic exenteration is a radical surgical procedure for advanced pelvic malignancies.
    • Supravesical urinary diversion is often required concurrently.
    • This procedure carries risks of short- and long-term complications.

    Purpose of the Study:

    • To evaluate the outcomes of pelvic exenteration with concurrent supravesical urinary diversion.
    • To assess the impact of surgical techniques, including gastrointestinal staplers and ureteral stents, on procedure time and complications.
    • To identify preferred methods for supravesical urinary diversion in this patient population.

    Main Methods:

    • Retrospective review of 119 pelvic exenterations performed between October 1969 and April 1981.

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  • Concurrent supravesical urinary diversion in 115 patients.
  • Analysis of conduit types (ileal, transverse colon, sigmoid) and use of gastrointestinal staplers and ureteral stents.

    • Main Results:

    • 56 anterior and 59 total exenterations were performed.
    • Ileal conduits were most common (97 patients), followed by transverse colon (16 patients).
    • Gastrointestinal staplers were used in 85 patients, reducing mean operating time by ~30% without increasing GI complications. Ureteral stents and staplers shortened procedures without major urologic complications.

    Conclusions:

    • Supravesical urinary diversion during pelvic exenteration can be performed safely.
    • The use of gastrointestinal staplers and ureteral stents shortens operative time without increasing urologic complications.
    • Employing a segment of unirradiated transverse colon for urinary diversion is the preferred technique.