1987 Volume 78 Issue 10 Pages 1740-1745
Transverse colon conduit urinary diversion was performed in 8 patients with pelvic malignancy, which was uterine cancer in 1 patient, bladder tumor in 6 and prostate cancer in 1. In 3 of these patients the transverse colon conduit was preferred to the ileal conduit because of a previous irradiation to the pelvic cavity which could have adversely affected the ileum and intrapelvic ureter. One patient, who developed bilateral hydronephrosis due to stenosis at the ureteroileal anastomosis sites following total cystectomy and ileal conduit for bladder tumor, underwent re-diversion using the transverse colon conduit. The ileal conduit was difficult to perform in this patient because of an extensive adhesion in the small intestine. The other 4 patients, who were expected to have a local recurrence after radical surgery, underwent the transverse colon conduit which was considered to be a favorable type of urinary diversion compared to the ileal conduit in the surgical manipulation and radiotherapy of the intrapelvic recurrent disease and was anticipated to delay urinary obstruction by the recurrent disease. The followup period of these patients ranged from 12 to 23 months (average 17 months). None of these patients except one who developed parastomal hernia at 6 months of follow up experienced postoperative complications. Hydronephrosis, which was seen on the preoperative excretory urogram in 3 patients, showed a marked improvement after the transverse colon conduit urinary diversion. The postoperative excretory urogram of 5 patients whose preoperative excretory urogram showed normal upper tract revealed mild hydronephrosis at 1 month of followup, which disappeared in most patients at 6 months of followup. None of these patients had a significant elevation of serum creatinine level after the transverse colon conduit, while one patient had an elevated preoperative serum creatinine level which became normal after the transverse colon conduit. No patients developed electrolyte disturbances.
