Cecal rupture after continent ileocecal urinary diversion during total pelvic exenteration

Journal Article · Sun Sep 01 04:00:00 EDT 1991 · Obstetrics and Gynecology; (United States)

OSTI ID:5159545

Brand, E ^[1]

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1. University of Colorado Health Sciences Center, Denver (USA)

Continent ureteral diversion at the time of pelvic exenteration avoids an external appliance and allows patients to retain bladder reservoir function. The technical difficulty of this procedure requires meticulous attention to operative and perioperative care, particularly after pelvic irradiation. A patient with recurrent stage IIIB carcinoma of the cervix underwent total pelvic exenteration with reconstructive procedures including low rectal anastomosis, neovagina formation, and ileocecal (Indiana) continent diversion. Early catheterization of the reservoir began 2 weeks postoperatively. One week later cecal rupture occurred, not related to suture line (technical) failure. Because of the high wall tension and reduced compliance in the irradiated cecum, the authors do not recommend catheterization of the urinary reservoir before 4-6 weeks. In order for continent diversion to become the standard diversion in exenteration patients, the major complication rate must remain comparable to that of noncontinent diversion.

• OSTI ID: 5159545
• Journal Information: Obstetrics and Gynecology; (United States), Journal Name: Obstetrics and Gynecology; (United States) Vol. 78:3 ( Pt 2); ISSN 0029-7844; ISSN OBGNA
• Country of Publication: United States
• Language: English

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