Retrograde ureteric stenting and ileus tube insertion for a safer reoperation after pelvic exenteration: a case report

A 64-year-old male had undergone open pelvic exenteration and urinary tract reconstruction with an ileal conduit for locally advanced rectal cancer. Six years later, he developed a late-onset perineal intestinal fistula and was scheduled for surgical treatment. Before reoperation, a transnasal ileus...

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Bibliographic Details
Published in:Clinical journal of gastroenterology 2022-06, Vol.15 (3), p.582-585
Main Authors: Ouchi, Akira, Komori, Koji, Kinoshita, Takashi, Sato, Yusuke, Tanaka, Tsutomu, Tajika, Masahiro, Yamaura, Hidekazu, Inaba, Yoshitaka, Shimizu, Yasuhiro
Format: Article
Language:English
Subjects:
Abdominal Surgery
Case Report
Colorectal Surgery
Gastroenterology
Hepatology
Humans
Ileus - etiology
Ileus - surgery
Intestinal Fistula - etiology
Intestinal Fistula - surgery
Intestinal Obstruction
Male
Medicine
Medicine & Public Health
Middle Aged
Pelvic Exenteration - adverse effects
Pelvic Exenteration - methods
Reoperation
Stents - adverse effects
Surgical Oncology
Ureter - surgery
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Summary:A 64-year-old male had undergone open pelvic exenteration and urinary tract reconstruction with an ileal conduit for locally advanced rectal cancer. Six years later, he developed a late-onset perineal intestinal fistula and was scheduled for surgical treatment. Before reoperation, a transnasal ileus tube was inserted toward the ileal fistula, and ureteric stents were placed by endoscopy into the bilateral ureters via an ileal conduit. After laparotomy, ureteric stents and an ileus tube were palpable in the ileal conduit and jejunum to the proximal ileum. Ileal transection and ileo-transverse bypass were safely performed. The patient showed satisfactory progress and was discharged from the hospital on postoperative day 14. Retrograde ureteric stenting and ileus tube insertion seems to present a less-invasive and effective method for a safer reoperation after pelvic exenteration.
ISSN:1865-7257
1865-7265
DOI:10.1007/s12328-022-01609-5