Objective
To report our experience with a noneverted stoma technique used in ileal conduit urinary
diversion. We successfully utilize this technique in patients when traditional everted
stoma maturation is difficult due to a thick abdominal wall, bulky mesentery, and
poor bowel compliance.
Methods
We retrospectively reviewed all patients who underwent surgical creation of ileal
conduit using a noneverted stoma technique between 2009 and 2018. We recorded demographic
and perioperative information, including 30-day postoperative complications, and stoma
appearance at last follow-up visit. Using R software, chi-square testing of the distribution
of stoma outcomes for obese and nonobese patients was performed.
Results
There were a total of 42 patients who underwent noneverted stoma maturation technique
by a single surgeon. Our cohort meets obese criteria with a mean body mass index (BMI)
of 30.2. Mean length of follow-up was 16.6 months (1-62). On follow-up, 35 (83.3%)
of stomas were pink and everted appearing, 4 (9.5%) were flush, small, or noneverted,
1 (2.3%) had an eschar or area of granulation tissue around the stoma, and 2 (4.7%)
did not have a stoma description documented. There were 9 (21%) stoma-related complications
in our cohort. There was no statistical difference in stoma outcomes between obese
(BMI > 30) and nonobese (BMI < 30) patients (P= .65).
Conclusion
Ileal conduit creation with a noneverted stoma provides good stoma protuberance in
patients with a thick abdominal wall, bulky mesentery, and poor bowel compliance.
This technique is safe and should be considered in patients in whom stoma maturation
is difficult.
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Publication history
Published online: August 10, 2020
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