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Transverse colon conduit urinary diversion in patients treated with very high dose pelvic irradiation
R Ravi1, A K Dewan, K K Pandey
1Cancer Institute (WIA), Adyar, Madras, India.
Objective:
To study the results of transverse colon conduit urinary diversion in patients receiving very high dose pelvic irradiation (> or = 65 Gy).
Patients And Methods:
Records were reviewed for 30 such patients who underwent transverse colon conduit as a primary form of urinary diversion between January 1986 and June 1992. Most of the conduits were constructed using refluxing ureterocolic anastomoses with stents.
Results:
There was no operative mortality. Although the procedure was associated with a complication rate of 37% and a re-operation rate of 20%, there were no bowel or urinary anastomotic leaks. The operation could be safely performed on patients with renal failure, with 83% of such patients showing normal or improved serum creatinine levels post-operatively.
Conclusion:
The advantages of transverse colon conduit urinary diversion are the use of non-irradiated bowel and ureters for diversion. We recommend it as a primary form of urinary diversion in these high risk cases.