Introduction
Total pelvic exenteration requires both urinary and stool diversion, usually achieved via bilateral stomas. The double-barrelled wet colostomy (DBWC) is a single stoma which diverts both the stool and urinary flow but keeps them separate. It also enables mobilisation of rectus abdominis as a myocutaneous flap to fill the perineum and avoids the need for a bowel anastomosis to form a separate ileal conduit.
Aims
To evaluate perioperative outcomes, early and late complications of DBWC formation

Methods
Patient data was collated prospectively. The following parameters were measured: baseline characteristics (Age, BMI, ASA, sex, extent and type of carcinoma, history of radiotherapy, neo-adjuvant chemotherapy, plastics reconstruction; perioperative outcomes (operative time, length of stay- ITU and total, transfusion, complications); renal function, biochemical changes; and long term complications

Results
41 patients underwent DBWC (27 male, 14 female – median age 62 years). Median BMI was 27.1 kg/m2. All patients received neo-adjuvant radiotherapy. 30 patients required a rectus abdominis flap. Early post-operative complications were common (Clavien-Dindo I – 4 patients, II – 15 patients, IIIa – 4 patients).
6 patients developed hydronephrosis at 12 weeks resulting in a modification in operative technique for subsequent patients. 2 patients have required revision to bilateral stomas.

Conclusion
The DBWC is a good option in selected patients. The ureteric anastomosis in these previously irradiated patients requires careful monitoring. A single stoma facilitates the use of rectus flap to fill the large perineal defect. Comparative study with bilateral stoma would be needed to facilitate better patient selection.