Introduction: The aim of this literature review was to analyse the advantages and disadvantages of a traditional ileal conduit (IC) with separate colostomy technique compared to the outcomes of a double-barrelled wet colostomy (DBWC) technique. The former technique results in the formation of two stomas, and the latter results in the formation of one stoma. Methods: PubMed was searched electronically for articles on DBWC. Fifteen articles were retrieved and of them 13 were included in the literature review (350 patients). Of the articles, 3 directly compared DBWC to IC with colostomy. Results: Review of 13 DBWC articles demonstrated perioperative mortality ranging between 0 and 11.1% and postoperative complications ranging from 0 to 100%. Three of the studies directly compared DBWC to IC with colostomy; median operating times and length of stay were shorter in DBWC patients (p < 0.001); 30-day morbidity was reported to either be lower in the DBWC group (p < 0.043) or to have no statistically significant difference. Rates of mortality, pyelonephritis, electrolyte disturbances and urinary anastomotic problems did not differ between the 2 groups. Conclusion: The DBWC technique inherently has a benefit over the IC with colostomy technique, as it requires only one stoma. This literature review supports the use of the technically less challenging DBWC technique as a viable alternative to the traditional IC with colostomy technique.

Keywords:
Pelvic exenteration, Ureterocolostomy, Wet colostomy
1.
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 1948;1:177-183.
2.
[Alexander Brunschwig (1901-1969)]. CA Cancer J Clin 1974;24:361-362.
3.
Lopes de Queiroz F, Barbosa-Silva T, Pyramo Costa LM, Werneck Côrtes BJ, Figueiredo JA, Guerra F, et al: Double-barrelled wet colostomy with simultaneous urinary and faecal diversion: results in 9 patients and review of the literature. Colorectal Dis 2006;8:353-359.
4.
Avradopoulos KA, Vezeridis MP, Wanebo HJ: Pelvic exenteration for recurrent rectal cancer. Adv Surg 1996;29:215-233.
5.
Petros JG, Augustinos P, Lopez MJ: Pelvic exenteration for carcinoma of the colon and rectum. Semin Surg Oncol 1999;17:206-212.
6.
Lopez MJ, Spratt JS: Exenterative pelvic surgery. J Surg Oncol 1999;72:102-114.
7.
Bricker EM: Bladder substitution after pelvic evisceration. Surg Clin North Am 1950;30:1511-1521.
8.
Carter MF, Dalton DP, Garnett JE: Simultaneous diversion of the urinary and fecal streams utilizing a single abdominal stoma: the double-barreled wet colostomy. J Urol 1989;141:1189-1191.
9.
Carter MF, Dalton DP, Garnett JE: The double-barreled wet colostomy: long-term experience with the first 11 patients. J Urol 1994;152(6 pt 2):2312-2315.
10.
Garde H, Ciappara M, Galante I, Fuentes Ferrer M, Gómez A, et al: Radical cystectomy in octogenarian patients: a difficult decision to take. Urol Int 2015;94:390-393.
11.
Berger I, Wehrberger C, Ponholzer A, Wolfgang M, Martini T, et al: Impact of the use of bowel for urinary diversion on perioperative complications and 90-day mortality in patients aged 75 years or older. Urol Int 2015;94:394-400.
12.
Pavlov MJ, Ceranic MS, Nale DP, Latincic SM, Kecmanovic DM: Double-barreled wet colostomy versus ileal conduit and terminal colostomy for urinary and fecal diversion: a single institution experience. Scand J Surg 2014;103:189-194.
13.
Backes FJ, Tierney BJ, Eisenhauer EL, Bahnson RR, Cohn DE, Fowler JM: Complications after double-barreled wet colostomy compared to separate urinary and fecal diversion during pelvic exenteration: time to change back? Gynecol Oncol 2013;128:60-64.
14.
Chokshi RJ, Kuhrt MP, Schmidt C, Arrese D, Routt M, Parks L, et al: Single institution experience comparing double-barreled wet colostomy to ileal conduit for urinary and fecal diversion. Urology 2011;78:856-862.
15.
Golda T, Biondo S, Kreisler E, Frago R, Fraccalvieri D, Millan M: Follow-up of double-barreled wet colostomy after pelvic exenteration at a single institution. Dis Colon Rectum 2010;53:822-829.
16.
Takada H, Yoshioka K, Boku T, Yoshida R, Nakagawa K, Matsuda T, Hioki K: Double-barreled wet colostomy. A simple method of urinary diversion for patients undergoing pelvic exenteration. Dis Colon Rectum 1995;38:1325-1326.
17.
Osorio Gullón A, de Oca J, Lopéz Costea MA, Virgili J, Ramos E, del Rio C, Martí Ragué J: Double-barreled wet colostomy: a safe and simple method after pelvic exenteration. Int J Colorectal Dis 1997;12:37-41.
18.
Blanco Díez A, Fernández Rosado E, Alvarez Castelo L, Sánchez Rodríguez-Losada J, Chantada Abal V, Novás Castro S, et al: [Double-barreled wet colostomy: analysis of a urinary diversion]. Actas Urol Esp 2003;27:611-617.
19.
Guimaraes GC, Ferreira FO, Rossi BM, Aguiar S Jr, Zequi SC, Bachega W, 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 2006;93:206-211.
20.
Kecmanovic DM, Pavlov MJ, Kovacevic PA, Sepetkovski AV, Ceranic MS, Stamenkovic AB: Management of advanced pelvic cancer by exenteration. Eur J Surg Oncol 2003;29:743-746.
21.
Sukumar S, Sivanandam E, Bhat HS, Mathew G, Sudheer OV, Dhar P: Revisiting the double-barreled wet colostomy for simultaneous urinary and fecal diversion - an Indian experience. Indian J Gastroenterol 2010;29:240-243.
22.
Salgado-Cruz L, Espin-Basany E, Vallribera-Valls F, Sanchez-Garcia J, Jimenez-Gomez LM, Marti-Gallostra M, Garza-Maldonado A: Double barreled wet colostomy: initial experience and literature review. ScientificWorldJournal 2014;2014:961409.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.