Comparison of survival in elderly patients treated with uretero-cutaneostomy or ileal conduit after radical cystectomy

Huang, Shang; Chen, Hanzhong; Li, Teng; Pu, Xiao‐Yong; Liu, Jiumin; Bi, Xiangjun

doi:10.1186/s12877-020-01861-9

Cited by 10 publications

(12 citation statements)

References 27 publications

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“…Postoperative quality of life. The type of urinary diversion does not affect overall survival, and the long-term quality of life is similar [9,17]. However, unilateral ureterostomy has also been reported to require fewer ostomy bags, impose lower nursing, nancial, and psychological burdens on the patient, and improve their mental state [26].…”

Section: Discussionmentioning

confidence: 99%

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

Zhang

Chen

et al. 2022

Preprint

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Purpose: The efficacy and complications of bilateral cutaneous ureterostomy with a single subumbilical stoma were compared with those of cutaneous ureterostomy with two stomas and an ileal conduit. 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 cystectomywere 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 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: The survival and complication rates of patients undergoing three different urinary diversion strategies after radical cystectomy were similar, but the operative time of the single-stoma group was shorter than that of the ileal conduit group. Compared with the two-stoma group, the single-stoma group had a significantly higher rate of successful first extubation and lower ostomy-related medical costs.

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Section: Discussionmentioning

confidence: 99%

“…The procedures for ureterostomy with two stomas and ileal conduit surgery were as described [8,9] Postoperative follow-up…”

Section: General Informationmentioning

confidence: 99%

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

Zhang

Chen

et al. 2022

Preprint

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“…Cutaneous ureterostomy (CU), which proves to be superior in Operative time, perioperative risks and anesthetic risks, has been an essential form for UD [9,10]. Sometimes unilateral abdominal wall ureterostomy is di cult to achieve due to obesity, abdominal type pelvic lipoatrophy and many other reasons, besides, bilateral abdominal wall ureterostomy also have various de ciencies in care, daily activities.…”

Section: Introductionmentioning

confidence: 99%

Robot-assisted radical cystectomy with the clinical application of "Y-shaped" end-to-side ureteral anastomosis in elderly and obese patients

Mou,

Mao,

Liu

et al. 2024

Preprint

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Objective: To investigate the clinical effect and safety of "Y-shaped" end-to-side ureteral anastomosis with robotic endoscopic technique in radical cystectomy (RC) and urinary diversion (UD) in elderly and obese patients with bladder cancer. Materials and methods: We retrospectively reviewed the records of 10 patients with bladder cancer who underwent robot-assisted laparoscopic radical cystectomy and "Y-shaped" end-to-side ureteral anastomosis under general anesthesia at Zhejiang Provincial People's Hospital (Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China, 310014) from October 2018 to January 2021. Demographic and clinical data are summarized. The incidence of postoperative complications such as papillary retraction, ureteral stricture, anastomotic stenosis, anastomotic fistula and ureteral calculi were observed and analyzed. Results: A total of 10 elderly and obese patients successfully underwent RC with "Y-shaped" end-to-side ureteral anastomosis in this research. Median age was (80.6±5.7)y and BMI was (25.12±3.83) kg/m2. The operation time was (95±26) min and the estimated intraoperative blood loss was (100.5±35.6) ml, with no perioperative blood transfusion and no readmission 30 days after operation. No serious complications above Clavien-Dindo grade 4 occurred in the early (≤30 d) and late (> 30 d) after surgery. 1 patient developed fever 3 days after operation and was cured by strengthening anti-infection. 1 patient had a small amount of urine leakage at the anastomotic site after operation, and recovered after strengthening nutrition and maintaining the patency of abdominal drainage tube and single J tube. Postoperatively, the patients replaced the single J tube regularly and were followed up for 3-28 months (average 15 months) until April 10, 2021. In 2 cases, the ureterostomy nipple was slightly retracted and collapsed without special treatment. 1 case formed ureteral calculi and was treated conservatively. No ureteral stenosis, necrosis, anastomotic stenosis or severe anastomotic fistula, hernia around the stoma occurred. No visceral metastases or new lesions of urothelial carcinoma were observed. All patients were satisfied with the postoperative quality of life. Conclusions: The robot-assisted "Y-shaped" end-to-side ureteral anastomosis technique performed intracorporeally seems to be a straightforward, secure, and viable approach. It is considered suitable for radical resection of bladder cancer and urinary diversion in elderly and obese patients.

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“…3,4 Continent orthotopic neobladder (ONB), incontinent ileal conduit (IC) and incontinent cutaneous ureterostomy (CU) are the most commonly utilized urinary diversions (UDs) after RC. 5 While CU is mostly reserved for the aged multimorbid patients who are incapable of bearing long operations 6 ; ONB and IC can be both performed in younger patients with only a few exclusions for each procedure. Nevertheless, controversy persists on the superior UD between ONB and IC.…”

Section: Introductionmentioning

confidence: 99%

Comparison of different urinary diversions after radical cystectomy in Iran: Assessment of health-related quality of life and financial burden in a Middle Eastern country

Basiri,

Zahir,

Soleimani

et al. 2023

Urologia

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Objectives: To compare health-related quality of life (HRQOL), cost-effectiveness, and survival among different types of urinary diversion (UD) utilized after radical cystectomy (RC) for bladder cancer with consideration of the unique economic and cultural context in Iran. Patients and methods: In this retrospective study, we examined all patients who underwent RC from May 2017 to December 2021 at two specialized centers by the same surgical team. Patients were grouped based on their UD. Post-surgical HRQOL (obtained from EORTC QLQ-C30 and QLQBLM-30), financial burden, surgical complications, and survival were compared. Kruskal-Wallis H test, One-way ANOVA, and Kaplan-Meier analyses were utilized; accordingly. Results and limitations: In total 187 patients were identified—orthotopic neobladder (ONB) ( N = 75), ileal conduit (IC) ( N = 57), and cutaneous ureterostomy (CU) ( N = 55)—and were followed for a median 17.5 (Interquartile range: 7.0, 47.0) months. ONB was associated with better HRQOL, especially in the domains addressing physical, role and social functioning ( p = 0.003, 0.011, 0.045) as well as better body image ( p < 0.001), lower short- and long-term financial burden ( p = 0.034 and <0.001, respectively), marginally lower complication rate ( p = 0.049), and better 5-year overall survival ( p < 0.001), in comparison with other UDs. Patients who underwent CU had the lowest HRQOL and worst survival. Limitations were retrospective design and possibility of selection bias. Conclusions: In this first study that assesses a Middle Eastern collective; ONB seems to be the UD of choice with regard to HRQOL and economic burden when there is no contraindication.

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Comparison of survival in elderly patients treated with uretero-cutaneostomy or ileal conduit after radical cystectomy

Cited by 10 publications

References 27 publications

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

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

Robot-assisted radical cystectomy with the clinical application of "Y-shaped" end-to-side ureteral anastomosis in elderly and obese patients

Comparison of different urinary diversions after radical cystectomy in Iran: Assessment of health-related quality of life and financial burden in a Middle Eastern country

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