Double barreled wet colostomy. Case report and description of the surgical technique

Abstract

Pelvic exenteration has showed to be beneficial therapeutically and palliatively in locally advanced colorectal cancer. Reconstruction of urinary transit posterior to a cystectomy has always been challenging with many associated complications. We present a 58-year-old male with locally advanced rectal cancer in which a pelvic exenteration and a double-barreled wet colostomy (DBWC) was created for urinary reconstitution. We present the surgical technique of DBWC. DBWC is a good alternative to other urinary reconstructions because fecal and urinary derivation occurs in only one stoma, the stoma output is easier to manage, and fewer complications are seen compared to other urinary reconstructions. Long-term surveillance is mandatory in patients with a DBWC because there is an increased risk of neoplasm in the reservoir.

The Colostomy Complications in Anorectal Malformation: A Retrospective Study

“…Most stoma formation was performed in the neonatal period because the patients with imperforate anus presented as an emergency, with intestinal obstruction immediately after birth. 5,7,8 In our hospital, most surgeons prefer to do pelvic colostomies, as the loop-type is used in 80% of the cases and the double barrel in 16%, because most cases do not required laparotomy. There are lower rates of complications, and it is easy to do distal colostogram to delineate the level of rectum end.…”

“…2,3 Complications may occur immediately after surgery, including: wound infection, abscess, peristomal fistula, stomal dysfunction, stomal retraction, bleeding, and small bowel obstruction, or there may be late complications, including: parastomal hernia, prolapse, stricture or stenosis, and poor shape and location of the stoma (skin excoriation). [4][5][6][7]…”