Ileal Loop in the Treatment of Radiation-Treated Pelvic Malignancies: A Comparative Review

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Abstract
Between 1970 and 1975, 136 adults with pelvic tumors underwent ureteroileal bypass. Of these patients 36 had preoperative irradiation for various pelvic malignancies, 44 had malignancies but no irradiation and 56 were operated on for neurogenic bladders. Major morbidity in the irradiated group included wound infections (33%), ureteroileal urinary leaks (19.4%) and paralytic ileus (13.9%). The average postoperative hospital stay for this group was 8-11 days longer than that of the other 2 groups. In contrast, the overall incidence of reoperations for various complications in the irradiated group was only 11%, compared to 25% in the group not given preoperative radiation and 30.4% of those operated on for neurogenic bladders. Most significantly, none of the patients in the irradiated group required re-exploration and surgical correction of ureteroileal urinary fistulas. Comparison of these results to those reported in the literature was favorable. The ileal loop remains a simple and viable operative technique in patients requiring urinary diversion for pelvic malignancies previously irradiated.