Urinary reconstruction following total pelvic exenteration for locally advanced rectal cancer: complications and factors affecting outcomes
| Autor: | Mufaddal Kazi, Jitender Rohila, Naveena AN Kumar, Sanket Bankar, Reena Engineer, Ashwin Desouza, Avanish Saklani |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Urinary system medicine.medical_treatment Anastomosis Urinary Diversion 03 medical and health sciences 0302 clinical medicine Postoperative Complications Medicine Humans Urinary Complication Retrospective Studies Pelvic exenteration business.industry Rectal Neoplasms Mortality rate Urinary diversion Rectum Vascular surgery Surgery Pelvic Exenteration 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology business Abdominal surgery |
| Zdroj: | Langenbeck's archives of surgery. 406(2) |
| ISSN: | 1435-2451 |
| Popis: | Total pelvic exenteration (TPE) for rectal cancers is associated with significant morbidity. We evaluated the complications related to urinary reconstruction following TPE and factors predicting urologic morbidity. Retrospective analysis of TPE patients with incontinent urinary diversions between August 2013 and January 2020. One hundred TPE were performed with 96 ileal conduits (IC). Early complications occurred in 10 patients that included uretero-ileal leaks (5%), conduit-related complications (3%), and acute pyelonephritis (3%). Late complications were seen in 26% of patients with uretero-intestinal strictures in 11%. Mortality attributable to urinary complications was seen in 2%. No single factor, including prior radiation, recurrent disease, type of anastomosis, or blood loss, predicted development of urinary morbidity. Conduit urinary diversion following TPE is associated with high urinary morbidity rate but low mortality. It can be safely performed even after previous surgeries and radiation by a dedicated colorectal team. |
| Databáze: | OpenAIRE |
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