Modified Technique to Prevent Complications Related to Stoma and Ileoureteral Anastomosis in Patients Undergoing Ileal Conduit Diversion

Zhang, Zhi Ling; Liu, Zhuo Wei; Zhou, Fang; Li, Yong Hong; Xiong, Yong Liang; Rao, Kai; Hou, Guo Liang; Han, Hongya; Qin, Zi Ke; Yu, Shao Long; Chen, Xiaofeng

doi:10.1016/j.urology.2009.09.086

Cited by 9 publications

(12 citation statements)

References 11 publications

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“…However, we believe that passing the stoma through the rectus abdominis is impractical in Asian patients because of their relatively small body build. In fact, in our previous study [23] and the present study the stoma was, without exception, located lateral to the rectus abdominis in all patients.…”

Section: Introductionsupporting

confidence: 44%

“…The technique of the modified ileal conduit diversion has been described in detail in our previous report [23]. Please see the brief video of the surgical process available at https://pan.baidu.com/s/13jsVs-jBqUkB_9ADzH3uOw.…”

Section: Methodsmentioning

confidence: 99%

“…We believe that the surgical technique is responsible for these complications, and therefore have devised a modified technique for creating the ileal conduit and the ureteroileal anastomosis that should help prevent these complications after surgery. Initial results showed that complications related to stoma and ureteroileal anastomosis were effectively prevented with the use of our modified technique [23]. The present retrospective study was aimed to compare the rates of early and late stoma- and ureteroileal anastomosis-related complications between patients undergoing conventional and modified ileal conduit surgery.…”

Section: Introductionmentioning

confidence: 99%

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An improved ileal conduit surgery for bladder cancer with fewer complications

Liu

Yao

et al. 2019

Cancer Communications

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Background Radical cystectomy and urinary diversion remains the standard surgical treatment for patients with muscle-invasive or high-risk or recurrent non-muscle-invasive bladder cancer. Although this approach prolongs patient survival remarkably, there are postoperative complications associated with urinary diversion. This study aimed to assess the efficacy of modified ileal conduit surgery for reducing early and late stoma- and ureteroileal anastomosis-related complications, as compared with conventional ileal conduit urinary diversion. Methods We retrospectively evaluated the clinical data of bladder cancer patients treated with radical cystectomy and ileal conduit urinary diversion at Sun Yat-sen University Cancer Center between January 1, 2000 and June 30, 2016. Ileal conduit was created by the conventional or a modified technique. The clinicopathologic features of the conventional and the modified ileal conduit groups were compared using the t test and the Chi square test. Multivariable logistic regression analysis and multivariable Cox regression analysis were performed to determine the odds of developing stoma- and ureteroileal anastomosis-related complications in the two groups. Results 145 and 100 patients underwent the modified and conventional ileal conduit surgery, respectively. The two groups were comparable with regard to clinicopathologic features. The rate of stoma-related complications was significantly lower in the modified ileal conduit group than in the conventional ileal conduit group (0.7% vs. 17.0%, P < 0.001). No late stoma-related complications were seen in the modified ileal conduit group, but were seen in 13 (13.0%) patients in the conventional ileal conduit group. The rate of ureteroileal anastomosis-related complications was significantly lower in the modified ileal conduit group than in the conventional ileal conduit group (4.8% vs. 15.0%, P = 0.001). In multivariable analyses, the modified ileal conduit group was significantly less likely to develop stoma- (odds ratio [OR] = 0.024, 95% confidence interval [CI] 0.003–0.235; P = 0.001) or ureteroileal anastomosis-related complications (OR = 0.141, 95% CI 0.042–0.476; P = 0.002) than the conventional ileal conduit group. Conclusions Our modified surgical technique for ileal conduit urinary diversion may be effective for reducing early and late complications related to the stoma and the ureteroileal anastomosis. Prospective randomized clinical trials are needed to confirm our results.

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Section: Introductionsupporting

confidence: 44%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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An improved ileal conduit surgery for bladder cancer with fewer complications

Liu

Yao

et al. 2019

Cancer Communications

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“…Studies investigating the frequencies of PSH after ileal conduit without a prophylactic mesh have reported rates between 0 and 29% [4][5][6][7][8][9][10][11]. The reported frequencies appear to have increased over the past 40 years.…”

Section: Discussionmentioning

confidence: 99%

“…One of the most frequent complications of an ileal conduit diversion is the development of a parastomal hernia (PSH), reported to occur in 0-29.1% of the patients [4][5][6][7][8][9][10][11]. Within the field of colorectal surgery, similar figures have been reported on the rate of PSH after end ileostomies [12].…”

Section: Introductionmentioning

confidence: 87%