Outcomes of urinary diversion after surgery for locally advanced or locally recurrent rectal cancer with complete cystectomy: ileal and colon conduit

J. A. W. Hagemans, E. L. K. Voogt*, J. Rothbarth, G. A. P. Nieuwenhuijzen, W. J. Kirkels, J. L. Boormans, E. L. Koldewijn, R. Richardson, C. Verhoef, H. J. T. Rutten, J. W. A. Burger

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

74 Downloads (Pure)


Introduction: Surgery for locally advanced rectal cancer (LARC) or locally recurrent rectal cancer (LRRC) may require total pelvic exenteration with the need for urinary diversion. The aim of this study was to describe outcomes for ileal and colon conduits after surgery for LARC and LRRC.

Methods: All consecutive patients from two tertiary referral centers who underwent total pelvic exenteration for LARC or LRRC between 2000 and 2018 with cystectomy and urinary reconstruction using an ileal or colon conduit were retrospectively analyzed. Short- (30 days) complications were described for an ileal and colon conduit.

Results: 259 patients with LARC (n = 131) and LRRC (n = 128) were included, of whom 214 patients received an ileal conduit and 45 patients a colon conduit. Anastomotic leakage of the ileo-ileal anastomosis occurred in 9 patients (4%) after performing an ileal conduit. Ileal conduit was associated with a higher rate of postoperative ileus (21% vs 7%, p = 0.024), but a lower proportion of wound infections than a colon conduit (14% vs 31%, p = 0.006). The latter did not remain significant in multivariate analysis. No difference was observed in the rate of uretero-enteric anastomotic leakage, urological complications, mortality rates, major complications (Clavien-Dindo >= 3), or hospital stay between both groups.

Conclusion: Performing a colon conduit in patients undergoing total pelvic exenteration for LARC or LRRC avoids the risks of ileo-ileal anastomotic leakage and may reduce the risk of a post-operative ileus. Besides, there are no other differences in outcome for ileal and colon conduits. (C) 2020 Elsevier Ltd, BASO - The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

Original languageEnglish
Pages (from-to)1160-1166
Number of pages7
JournalEuropean Journal of Surgical Oncology
Issue number6
Publication statusPublished - Jun 2020


  • Pelvic exenteration
  • Rectal cancer
  • Urinary diversion
  • lleal conduit
  • Colon conduit

Cite this