Analysis of the efficacy of a single subumbilical stoma for bilateral cutaneous ureterostomy after radical cystectomy

Abstract

Background Radical cystectomy and urinary diversion are the standard surgical treatments for patients with muscle-invasive or high-risk, or recurrent non-muscle-invasive bladder cancer. Although this approach significantly prolongs patient survival, it can lead to postoperative complications. This study aims to compare the efficacy and complications of bilateral cutaneous ureterostomy with a single subumbilical stoma to those of cutaneous ureterostomy with two stomas and an ileal conduit as a means of urinary diversion after radical cystectomy. The findings of this study will provide valuable information for healthcare providers in selecting the appropriate urinary diversion method for their patients. Methods The clinical data for 108 patients who received bilateral cutaneous ureterostomy with a single subumbilical stoma (ureterostomy with a single stoma group), cutaneous ureterostomy with two stomas (ureterostomy with two stomas group), or an ileal conduit (ileal conduit group) after radical cystectomy were retrospectively analysed. The operative time, pathological stage, survival status, perioperative complication rate, rate of successful first extubation, rehospitalization rate at 6 months after surgery,ostomy-related medical costs,and postoperative quality of life were compared between the three groups of patients. Results A significant difference in the operative time was found between the three groups (P = 0.001). No significant differences in pathological stage, survival status, perioperative complication rate, rehospitalization rate at 6 months after surgery, or bladder cancer index (BCI) score were identified among the three groups. The difference in the successful first extubation rate between the three groups of patients was significant (P = 0.001). Significant differences in ostomy-related medical costs were observed among the three groups of patients (P = 0.006). Conclusion A single subumbilical stoma for bilateral cutaneous ureterostomy after radical cystectomy may result in shorter surgery time, increased success rates for initial catheter removal, and lower medical expenses. However, to confirm these findings, further prospective randomized clinical trials are necessary.

Assessing the safety and feasibility of a new cutaneous ureterostomy suture approch (flap embedding approch ) after radical cystectomy :protocol for an open label, single-center, phase I clinical trial

“…Following RC, the most common complications are gastrointestinal complications, infections, traumarelated issues, and genitourinary system defects [19,20] . Perioperative complications not only result in prolonged hospital stays, increased medical costs, and decreased quality of life for patients, but they also impose a signi cant burden on healthcare resources [21] . Therefore, it is crucial to carefully assess the bene ts and risks of different urinary diversion procedures and identify strategies to minimize perioperative complications in patients undergoing RC.…”

Shame in patients undergoing ureterostomy: A cross‐sectional survey

“…Patients with ureterostomy drain urine through ureteral stent tube, and one end of ureteral stent tube is connected to kidney and the other end to make pocket to collect urine, which changes the normal mode of urination of patients. The patient cannot freely control the micturition time and needs to collect urine with the help of a urine reservoir (including a pocket and a stoma chassis) 8 . Most of the patients with ureterostomy are the elderly, and their hands‐on ability and physical flexibility have been weakened.…”

“…The patient cannot freely control the micturition time and needs to collect urine with the help of a urine reservoir (including a pocket and a stoma chassis). 8 Most of the patients with ureterostomy are the elderly, and their hands‐on ability and physical flexibility have been weakened. When pasting the pocket, it is easy to cause urine extravasation, which leads to peculiar smell and social disorder.…”