An improved ileal conduit surgery for bladder cancer with fewer complications
Abstract 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 asso...
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| Format: | Article |
| Language: | English |
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Wiley
2019-04-01
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| Series: | Cancer Communications |
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| Online Access: | http://link.springer.com/article/10.1186/s40880-019-0366-8 |
| _version_ | 1818281516211372032 |
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| author | Zhiyong Li Zhuowei Liu Kai Yao Zike Qin Hui Han Yonghong Li Pei Dong Yunlin Ye Yanjun Wang Zhiming Wu Zhiling Zhang Fangjian Zhou |
| author_facet | Zhiyong Li Zhuowei Liu Kai Yao Zike Qin Hui Han Yonghong Li Pei Dong Yunlin Ye Yanjun Wang Zhiming Wu Zhiling Zhang Fangjian Zhou |
| author_sort | Zhiyong Li |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-12-13T00:06:21Z |
| format | Article |
| id | doaj.art-d3530276738944debe54c2b0e253b732 |
| institution | Directory Open Access Journal |
| issn | 2523-3548 |
| language | English |
| last_indexed | 2024-12-13T00:06:21Z |
| publishDate | 2019-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cancer Communications |
| spelling | doaj.art-d3530276738944debe54c2b0e253b7322022-12-22T00:06:15ZengWileyCancer Communications2523-35482019-04-0139111010.1186/s40880-019-0366-8An improved ileal conduit surgery for bladder cancer with fewer complicationsZhiyong Li0Zhuowei Liu1Kai Yao2Zike Qin3Hui Han4Yonghong Li5Pei Dong6Yunlin Ye7Yanjun Wang8Zhiming Wu9Zhiling Zhang10Fangjian Zhou11Department of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterDepartment of Urology, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer CenterAbstract 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.http://link.springer.com/article/10.1186/s40880-019-0366-8Bladder cancerCystectomyUrinary diversionIleal conduitComplicationSurgical technique |
| spellingShingle | Zhiyong Li Zhuowei Liu Kai Yao Zike Qin Hui Han Yonghong Li Pei Dong Yunlin Ye Yanjun Wang Zhiming Wu Zhiling Zhang Fangjian Zhou An improved ileal conduit surgery for bladder cancer with fewer complications Cancer Communications Bladder cancer Cystectomy Urinary diversion Ileal conduit Complication Surgical technique |
| title | An improved ileal conduit surgery for bladder cancer with fewer complications |
| title_full | An improved ileal conduit surgery for bladder cancer with fewer complications |
| title_fullStr | An improved ileal conduit surgery for bladder cancer with fewer complications |
| title_full_unstemmed | An improved ileal conduit surgery for bladder cancer with fewer complications |
| title_short | An improved ileal conduit surgery for bladder cancer with fewer complications |
| title_sort | improved ileal conduit surgery for bladder cancer with fewer complications |
| topic | Bladder cancer Cystectomy Urinary diversion Ileal conduit Complication Surgical technique |
| url | http://link.springer.com/article/10.1186/s40880-019-0366-8 |
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