Long-Term Outcomes of Patients Who Underwent Ureterocutaneostomy

Kızılay, Fuat; Şimşir, Adnan; Cüreklibatir, Ibrahim; Çal, Çağ

doi:10.4274/uob.978

Cited by 5 publications

(7 citation statements)

References 21 publications

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“…Acute pyelonephritis was diagnosed in eight patients (22.22%) postoperatively, although all patients were found to have a positive culture in urine collected from their nephrostomy tube. This incidence is in accordance with the reported in the literature for uretero-cutaneostomy and transuretero-cutaneostomy (2.27%-42.30%) [24][25][26][27]. In six patients, acute pyelonephritis resulted from complications related to the nephrostomy tube (dislocation in three, obstruction and hydronephrosis in two, and post-replacement pyelonephritis in one).…”

Section: Discussionsupporting

confidence: 90%

Uretero-Ureterostomy Combined With Unilateral Nephrostomy as a Method of Urinary Diversion Following Radical Cystectomy

Papadimitriou¹,

Deliveliotis²,

Dellis³

et al. 2022

Cureus

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IntroductionUretero-ureterostomy combined with unilateral nephrostomy is a rarely performed urinary diversion following radical cystectomy for muscle-invasive bladder cancer. The aim of this study is to assess the efficacy and safety of the procedure. Materials and methodsPatients with muscle-invasive bladder cancer and poor performance status were enrolled in this retrospective, observational, single-centre study, carried out between December 2018 and November 2020. The patient's renal function was regularly assessed with serum creatinine and estimated glomerular filtration rate (eGFR). Evaluation of peri-and postoperative complications was performed based on clinical, laboratory, endoscopic, ultrasound and other radiological studies findings. The patient's status was assessed for 12 months. ResultsThirty-six patients with a mean age of 77.4±8.6 years were enrolled in the study. 86.11% of patients had an American Society of Anesthesiologists Score ≥3 and 91.66% had an age-adjusted Charlson comorbidity index of ≥6. Slight deterioration of renal function, although not statistically significant, was observed. 36.11% of the patients developed permanent unilateral pelvic dilatation. Acute pyelonephritis, urosepsis, pyonephrosis and anastomotic leak were observed in 22.22%, 8.33%, 5.55% and 5.55% of patients, respectively; all were treated either conservatively and/or with minimally invasive procedures (nephrostomy, JJ-stent insertion) without any need for open surgical revision. ConclusionsUreteroureterostomy combined with unilateral nephrostomy is a safe and effective method of urinary diversion following radical cystectomy for muscle-invasive bladder cancer with easily manageable complications.

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Section: Discussionsupporting

confidence: 90%

Uretero-Ureterostomy Combined With Unilateral Nephrostomy as a Method of Urinary Diversion Following Radical Cystectomy

Papadimitriou¹,

Deliveliotis²,

Dellis³

et al. 2022

Cureus

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“…In 1852, Simon first described the urinary diversion procedure and Bricker in 1950 popularized the ileal conduit (IC) technique [5]. Since then, this procedure has become popular among surgeons and is considered the first option for urinary diversion procedures [6]. Meanwhile, Johnston described uretero-cutaneostomy in 1963 for a patient with congenital urinary obstruction [7].…”

mentioning

confidence: 99%

“…Additionally, an IC procedure requires an intestinal segment as a urinary diversion, while uretero-cutaneostomy can avoid the complications associated with bowel anastomosis [6]. However, several studies have shown this procedure has a high incidence of ascending infection and stoma stenosis [6,9]. Meanwhile, both procedures showed the same result concerning the patients' quality of life [10].…”

mentioning

confidence: 99%

Comparing the outcome of ileal conduit and transuretero-cutaneostomy urinary diversion after radical cystectomy: a retrospective cohort study

et al. 2021

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Background Most of the outcomes after radical cystectomy (RC) are directly associated with the type of urinary diversion. This study sets out to evaluate the outcomes of ileal conduit (IC) and transuretero-cutaneostomy (TUC) urinary diversion after RC. Methods This retrospective study included 52 patients (IC, n = 30; TUC, n = 22) at Dr. Sardjito Hospital between January 2014 and December 2019. The clinical outcomes were compared using Chi-squared tests and independent t tests. Multivariable logistic regression analysis was performed to determine the odds of developing related complications. Results Demographically, both groups were similar in terms of age, gender, ASA score, staging, body mass index, and comorbidities. IC was associated with a high incidence of postoperative complications than TUC (56.7% vs. 27.3%; p = 0.035). Long-term postoperative complications stoma stenosis was more common in the TUC than IC (p = 0.010). Multivariate analysis showed TUC was a significant predictor for stoma stenotic with odds ratio of 1.29 (95% confidence interval, 1.03–1.62; p = 0.006). Meanwhile, metabolic change was found higher in IC (p = 0.047). No difference between the rate of required blood transfusion, postoperative ileus, re-operation, and anastomotic stricture in both groups. Operative time (p = 0.000) and length of stay (p = 0.002) were lower in patients who underwent TUC. The hospitalized cost was also lower in TUC ($ 2311.8 ± 1448 for IC vs. $ 1844.2 ± 948.8 for TUC; p = 0.005). Nonetheless, the follow-up cost was higher in the TUC but not statistically significant. Additionally, there was no difference between the overall satisfaction and diversion-related symptoms scores in both groups. The psychological score was better in IC groups. Conclusions Both of these techniques can be an option in a urinary diversion after RC with various advantages and disadvantages. TUC provides reduced complication rates, operative time, shorter length of stay, and hospitalized costs, but IC may reduce postoperative stoma stenosis complications and better psychological function.

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“…Rectal resection and termino-terminal sigmorectal anastomosis and a preventive colostomy were performed due to the suspected rectal infiltration and absence of surgical cleavage plane from the cervix. Because of the ileal resection, ileal conduit urinary diversion according to the Bricker technique was contraindicated; therefore, we opted for a left ureterocutaneostomy [ 4 , 5 ]. In addition, the right ureter showed neoplastic infiltration in the inferior third, and therefore, we removed the infiltrated tissue and closed the ureter (as the patient had already undergone a right nephrostomy).…”

Section: Case Reportmentioning

confidence: 99%

Diagnostic Framework of Pelvic Massive Necrosis with Peritonitis following Chemoradiation for Locally Advanced Cervical Cancer: When Is the Surgery Not Demandable? A Case Report and Literature Review

et al. 2022

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Concurrent platinum-based chemoradiation (CCRT) is the established treatment for locally advanced cervical cancer and has an acceptable toxicity. Radiation-induced necrosis of the uterus and pelvic tissue is a rare and usually late potential complication. Limited data are available about its management. Here, we describe a case of a patient affected by a locally advanced cervical cancer (stage IVA) who received CCRT, obtaining a partial response with persistence of bladder and rectal infiltration. Unfortunately, after the first brachytherapy dose, the patient developed a worsening clinical picture with fever and altered laboratory data indicative of sepsis; the computed tomography revealed a massive necrosis of the uterus with pelvic abscess and peritonitis. We performed a laparoscopic emergency surgery with removal of the necrotic tissue, supracervical hysterectomy, bilateral-oophorectomy, and abscess drainage. Thereafter, once the severe inflammatory condition was resolved, the patient underwent pelvic exenteration with palliative/curative intent. The postoperative PET/CT was negative for residual disease. However, the patient needed further hospitalization for re-occurrence of peritonitis with multiple abscesses. A careful diagnosis is crucial in locally advanced cervical cancer patients who, after CCRT, present persistent pain and problematic findings at imaging and laboratory parameters. In these cases, radiation-induced necrosis of the pelvis should be suspected. This case helps to clarify the central role of surgery, especially when actinic necrosis leads to complications such as abscess, fistulae, and extensive tissue destruction that cannot be conservatively medically handled. Laparoscopy represents an ideal approach to realizing the correct diagnosis, as well as enabling the performance of important therapeutic surgical procedures.

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Long-Term Outcomes of Patients Who Underwent Ureterocutaneostomy

Cited by 5 publications

References 21 publications

Uretero-Ureterostomy Combined With Unilateral Nephrostomy as a Method of Urinary Diversion Following Radical Cystectomy

Uretero-Ureterostomy Combined With Unilateral Nephrostomy as a Method of Urinary Diversion Following Radical Cystectomy

Comparing the outcome of ileal conduit and transuretero-cutaneostomy urinary diversion after radical cystectomy: a retrospective cohort study

Diagnostic Framework of Pelvic Massive Necrosis with Peritonitis following Chemoradiation for Locally Advanced Cervical Cancer: When Is the Surgery Not Demandable? A Case Report and Literature Review

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