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Since its initial description by Brunschwig in 1948 [1], pelvic exenteration has become an established procedure to treat locally advanced or recurrent gastrointestinal, gynecologic and urologic malignancies as well as after failure of other options for radiation cystitis/colitis and neurogenic bladder/bowel. This procedure typically involves en bloc removal of the remaining pelvic viscera: bladder, rectum, and prostate/seminal vesicles in males or uterus and vagina (partial or complete) in females [2]. Given the extensive resection and reconstruction involved, frequent prior radiation, and prevalence of adhesions from multiple prior procedures, perioperative complications are commonly encountered [3,4]. Such complications may prolong the hospital length of stay, and consequently increase overall healthcare costs. Anastomotic leak, post-operative ileus, and bowel obstruction have been shown in previous studies to be the most important factors contributing to a prolonged hospital stay following a pelvic exenteration [5]. Anastomotic leaks have been shown, on average, to prolong hospital length of stay between 19 and 36 days with many patients requiring pelvic drain placement and intravenous antibiotic use. Thus, urinary and fecal diversion surgical techniques that avoid bowel anastomosis have the potential to decrease periand postoperative morbidities with resultant decreased hospital length of stay and lower health care costs [5,6].

experimental techniques in urology and nephrology

No Anastomosis" Combined Colon Conduit and Colostomy Diversion with Pelvic Exenteration: An Underutilized, Cost-Effective Technique Reducing Bowel Complications