Single institution experience comparing double-barreled wet colostomy to ileal conduit for urinary and fecal diversion

2.50
Hdl Handle:
http://hdl.handle.net/10755/203247
Type:
Presentation
Title:
Single institution experience comparing double-barreled wet colostomy to ileal conduit for urinary and fecal diversion
Abstract:
(Summer Institute) Problem: Quality of life changes occur in patients undergoing pelvic exenteration with both ileal conduits and double barrel wet colostomy. Given these quality of life changes, is there a difference in median survival, operative time, length of stay or complications between the above groups? Evidence: Evidence used to address the problem was gathered from nursing and surgical literature. Strategy: A chart review was conducted evaluating median survival, operative time, length of stay, and complication rate for two matched groups at The James Cancer Hospital. Practice Change: Ongoing evaluation and management of fluid/electrolyte disturbances and peristomal skin irritation were implemented. It was identified monitoring needs to be ongoing and not limited to the immediate post-operative period. Evaluation: Developed an evaluation tool to retrospectively evaluate the patient population undergoing pelvic exenteration. Results: There was no difference found in median survival, operative time, length of stay or complications. Recommendations: Continue to gather data related to post-pelvic exenteration quality of life for dissemination to the surgical and nursing community in order to improve patient outcomes. Lessons Learned: The James Cancer Hospital has one of the largest experiences with double barrel wet colostomies and its subsequent complications affecting quality of life. Bibliography: Al-Refaie W, Parsons H, Henderson W, et al. Major cancer surgery in the elderly: results from the American College of Surgeons National Surgical Quality Improvement Program. Ann Surg.2010; 251(2):311-8. Austin K, Young J, Solomon M. Quality of life of survivors after pelvic exenteration for rectal cancer. Dis Colon Rectum. 53(8):1121-6, 2010. Bricker E, Modlin J. The role of pelvic evisceration in surgery. Surgery. 30(1):76-94, 1951. Brunschwig A. Complete excision of pelvic viscera for advanced carcinoma: a one-stage abdominoperineal operation with end colostomy and bilateral ureteral implantation into the colon above the colostomy . Cancer. 1(2):177-83, 1948. Carter MF, Dalton DP and Garnett JE. Simultaneous diversion of the urinary and fecal streams utilizing a single abdominal stoma: the double barreled wet colostomy. J Urol. 141:249-54, 1989. Delacroix S, and Winters J. Bladder reconstruction and diversion during colorectal surgery. Clin Colon Rectal Surg. 23(2):113-8, 2010. Finlayson CA, and Eisenberg BL. Palliative pelvic exenteration: patient selection and results. Oncology. 10(4):479-84, 1996. Gannon C, Zager J, Chang G, et al. Pelvic exenteration affords safe and durable treatment for locally advanced rectal carcinoma. Ann Surg Oncol. 14(6):1870-7, 2007. Golda T, Biondo S, Kreisler E, et al. Follow-up of double-barreled wet colostomy after pelvic exenteration at a single institution. Dis Colon Rectum. 53(5):822-9, 2010. Guimaraes GC, Ferreira FO, Rossi BM, et al. Double-barreled wet colostomy is a safe option for simultaneous urinary and fecal diversion; analysis of 56 procedures from a single institution. J Surg Oncol. 93(3):206-11, 2006. Gullon A, Oca J, Costea M, et al. Double-barreled wet colostomy: a safe and simple method after pelvic exenteration. International Journal of Colorectal Disease. 12:37-41, 1997. Jimenez R, Shoup M, Cohen A, et al. Contemporary outcomes of total pelvic exenteration in the treatment of colorectal cancer. Dis Colon Rectum. 46(12):1619-25, 2003. Kecmanovic D, Pavlov M, Ceranic, M, et al. Double-barreled wet colostomy: urinary and fecal diversion. J Urol. 180: 201-5, 2008. Mirnezami A, Sagar P, Kavanagh D, et al. Clinical algorithms for the surgical management of locally recurrent rectal cancer. Dis Colon Rectum. 53(9): 1248-57, 2010. Pandey D, Zaidi S, Hahajan V, et al. Pelvic exenteration: a perspective from a regional cancer center in india. Ind J Cancer. 41(3):109-14, 2004. Pierce M, Rice M, Fellows J. Wet colostomy and peristomal skin breakdown. J Wound Ostomy Continence Nurs. 33(5): 541-8, 2006. Roos E, Graeff A, Eijkeren M, et al. Quality of life after pelvic exenteration. Gynecol Oncol. 93:610-4, 2004. Well B, Stotland P, Ko M, et al. Results of an aggressive approach to resection of locally recurrent rectal cancer. Ann Surg Oncol. 14(2):309-95, 2007. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]
Keywords:
Colostomy; Diversion
Repository Posting Date:
16-Jan-2012
Date of Publication:
3-Jan-2012
Sponsors:
UTHSCSA Summer Institute

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleSingle institution experience comparing double-barreled wet colostomy to ileal conduit for urinary and fecal diversionen_GB
dc.identifier.urihttp://hdl.handle.net/10755/203247-
dc.description.abstract(Summer Institute) Problem: Quality of life changes occur in patients undergoing pelvic exenteration with both ileal conduits and double barrel wet colostomy. Given these quality of life changes, is there a difference in median survival, operative time, length of stay or complications between the above groups? Evidence: Evidence used to address the problem was gathered from nursing and surgical literature. Strategy: A chart review was conducted evaluating median survival, operative time, length of stay, and complication rate for two matched groups at The James Cancer Hospital. Practice Change: Ongoing evaluation and management of fluid/electrolyte disturbances and peristomal skin irritation were implemented. It was identified monitoring needs to be ongoing and not limited to the immediate post-operative period. Evaluation: Developed an evaluation tool to retrospectively evaluate the patient population undergoing pelvic exenteration. Results: There was no difference found in median survival, operative time, length of stay or complications. Recommendations: Continue to gather data related to post-pelvic exenteration quality of life for dissemination to the surgical and nursing community in order to improve patient outcomes. Lessons Learned: The James Cancer Hospital has one of the largest experiences with double barrel wet colostomies and its subsequent complications affecting quality of life. Bibliography: Al-Refaie W, Parsons H, Henderson W, et al. Major cancer surgery in the elderly: results from the American College of Surgeons National Surgical Quality Improvement Program. Ann Surg.2010; 251(2):311-8. Austin K, Young J, Solomon M. Quality of life of survivors after pelvic exenteration for rectal cancer. Dis Colon Rectum. 53(8):1121-6, 2010. Bricker E, Modlin J. The role of pelvic evisceration in surgery. Surgery. 30(1):76-94, 1951. Brunschwig A. Complete excision of pelvic viscera for advanced carcinoma: a one-stage abdominoperineal operation with end colostomy and bilateral ureteral implantation into the colon above the colostomy . Cancer. 1(2):177-83, 1948. Carter MF, Dalton DP and Garnett JE. Simultaneous diversion of the urinary and fecal streams utilizing a single abdominal stoma: the double barreled wet colostomy. J Urol. 141:249-54, 1989. Delacroix S, and Winters J. Bladder reconstruction and diversion during colorectal surgery. Clin Colon Rectal Surg. 23(2):113-8, 2010. Finlayson CA, and Eisenberg BL. Palliative pelvic exenteration: patient selection and results. Oncology. 10(4):479-84, 1996. Gannon C, Zager J, Chang G, et al. Pelvic exenteration affords safe and durable treatment for locally advanced rectal carcinoma. Ann Surg Oncol. 14(6):1870-7, 2007. Golda T, Biondo S, Kreisler E, et al. Follow-up of double-barreled wet colostomy after pelvic exenteration at a single institution. Dis Colon Rectum. 53(5):822-9, 2010. Guimaraes GC, Ferreira FO, Rossi BM, et al. Double-barreled wet colostomy is a safe option for simultaneous urinary and fecal diversion; analysis of 56 procedures from a single institution. J Surg Oncol. 93(3):206-11, 2006. Gullon A, Oca J, Costea M, et al. Double-barreled wet colostomy: a safe and simple method after pelvic exenteration. International Journal of Colorectal Disease. 12:37-41, 1997. Jimenez R, Shoup M, Cohen A, et al. Contemporary outcomes of total pelvic exenteration in the treatment of colorectal cancer. Dis Colon Rectum. 46(12):1619-25, 2003. Kecmanovic D, Pavlov M, Ceranic, M, et al. Double-barreled wet colostomy: urinary and fecal diversion. J Urol. 180: 201-5, 2008. Mirnezami A, Sagar P, Kavanagh D, et al. Clinical algorithms for the surgical management of locally recurrent rectal cancer. Dis Colon Rectum. 53(9): 1248-57, 2010. Pandey D, Zaidi S, Hahajan V, et al. Pelvic exenteration: a perspective from a regional cancer center in india. Ind J Cancer. 41(3):109-14, 2004. Pierce M, Rice M, Fellows J. Wet colostomy and peristomal skin breakdown. J Wound Ostomy Continence Nurs. 33(5): 541-8, 2006. Roos E, Graeff A, Eijkeren M, et al. Quality of life after pelvic exenteration. Gynecol Oncol. 93:610-4, 2004. Well B, Stotland P, Ko M, et al. Results of an aggressive approach to resection of locally recurrent rectal cancer. Ann Surg Oncol. 14(2):309-95, 2007. [© Academic Center for Evidence-Based Practice, 2011. http://www.acestar.uthscsa.edu]en_GB
dc.subjectColostomyen_GB
dc.subjectDiversionen_GB
dc.date.available2012-01-16T11:05:41Z-
dc.date.issued2012-01-03en_GB
dc.date.accessioned2012-01-16T11:05:41Z-
dc.description.sponsorshipUTHSCSA Summer Instituteen_GB
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