Stomal complications of intestinal conduit urinary diversion
Eric A. Klein, MDAddress reprint requests to E.A.K., Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, New York 10021.
James E. Montie, MD
Drogo K. Montague, MD
Andrew C. Novick, MD
Ralph A. Straffon, MD
Intestinal conduits of the ileum, colon, or jejunum were used for urinary diversion in 319 patients at The Cleveland Clinic Foundation between 1970 and 1981 due to pelvic malignancy, primary bladder cancer, or benign conditions. End stomas were constructed in 65% and Turnbull loop stomas in 35%. Follow-up ranged from one to 152 months (median, 35 months). The mean number of days between appliance changes was 5.7 (range, 2–10). The overall complication rate was 8.5%. Stomal revisions were required in 5%. There were no significant differences in the mean number of days between appliance changes, type or number of complications, or rate of revision between end and loop stomas or between the various intestinal segments used for diversion. The presence or absence of previous irradiation and the indication for diversion were independent of complications. Stomas constructed from any segment of the intestinal tract in end or loop fashion yielded equivalent long-term function and complication rates. Stomal complications can be minimized and the time between appliance changes maximized by careful attention to all phases of stomal construction and care.