Literature Review: Double-Barrelled Wet Colostomy (One Stoma) versus Ileal Conduit with Colostomy (Two Stomas)

Abstract

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.

Novel use of the Bakri balloon to minimize empty pelvis syndrome following laparoscopic total pelvic exenteration

“…Omental flaps may prove beneficial following abdominoperineal excision [5][6][7] but are hardly sufficient in bulk following total pelvic exenteration. The vertical rectus abdominis myocutaneous flap is a feasible option, along with a double-barrelled wet colostomy [17]. However, it is associated with donor site morbidity, is not feasible via a laparoscopic approach and still fails to keep the small bowel out of the pelvis.…”

Double-barrel wet colostomy after total pelvic exenteration

“…To avoid these drawbacks, double-barrel wet colostomy has been proposed as an alternative method to classical reservoirs using two stomas. 2 If we compare the use of the Bricker procedure and end colostomy with double barrel wet colostomy, the latter presents the following advantages: it is technically easier, requires only one stoma, avoids small bowel anastomosis (previous radiation may predispose to leaks) and reduces surgical time. 3 4 No differences have been reported in the rate of postoperative complications.…”

“…3 4 No differences have been reported in the rate of postoperative complications. 2 Additionally, double-barrel wet colostomy is less complex for the patients regarding the stoma management and care, resulting in better selfperception by the patient.…”

“…During the postoperative period, several studies have demonstrated there is no statistically significant difference in the rate of postoperative complications such as stenosis of the uretero-intestinal anastomosis, obstructive nephropathy, formation of calculi in the conduit, urinary infections or electrolyte imbalances (Table 1). [1][2][3][4] The urine drains into a reservoir distal to the stoma; consequently, the mixture of fecal content with urine and the resultant Video article ascending pyelonephritis is greatly reduced. Furthermore, with adequate stoma care and regular change of collection appliances, peristomal dermatitis and other local skin complications can be avoided or easily controlled.…”

“…If we compare the use of the Bricker procedure and end colostomy with double barrel wet colostomy, the latter presents the following advantages: it is technically easier, requires only one stoma, avoids small bowel anastomosis (previous radiation may predispose to leaks) and reduces surgical time 3 4. No differences have been reported in the rate of postoperative complications 2. Additionally, double-barrel wet colostomy is less complex for the patients regarding the stoma management and care, resulting in better self-perception by the patient.…”