MP25-07 INCIDENCE OF HIGH GRADE COMPLICATIONS AND ASSOCIATED READMISSION RATES FOLLOWING COLON CONDUIT URINARY DIVERSION

Abstract

You have accessJournal of UrologyCME1 May 2022MP25-07 INCIDENCE OF HIGH GRADE COMPLICATIONS AND ASSOCIATED READMISSION RATES FOLLOWING COLON CONDUIT URINARY DIVERSION Kevin Hebert, Ryan Anderson, Rano Matta, Benjamin McCormick, and Jeremy Myers Kevin HebertKevin Hebert More articles by this author , Ryan AndersonRyan Anderson More articles by this author , Rano MattaRano Matta More articles by this author , Benjamin McCormickBenjamin McCormick More articles by this author , and Jeremy MyersJeremy Myers More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002568.07AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Use of colon for urinary conduit diversion is often performed when there is a lack of viable ileum due to inflammatory small bowel disease, prior small bowel resection, or radiation related changes as a result of prior pelvic radiation. While short and long-term outcomes have been well studied in the ileal conduit population, there is a paucity of evidence assessing complications following colon conduit urinary diversion. Thus, we sought to elucidate the incidence and impact of high-grade complications (Clavien-Dindo IIIa-V) following colon conduit urinary diversion. METHODS: We performed a single institution, retrospective cohort study of patients undergoing colon conduit urinary diversion between April 2011 – January 2021. Perioperative characteristics were assessed including prior radiation, albumin, prealbumin, creatinine, and eGFR. Post-operative 30 and 90-day outcomes were characterized including length of stay, high-grade complication rates, readmission rates, and 90-day procedural/surgery rate. RESULTS: We identified 36 patients, median age 60 years [IQR 52,70] who underwent colon conduit urinary diversion during our study period. Colon segments utilized included transverse colon (63.8%), colon switch (19.4%), and sigmoid colon (16.7%). Active tobacco use at the time of surgery occurred in 14.8% of patients. Prior radiotherapy was common with 76.5% and 22.2% reporting prior history of external beam radiation and brachytherapy, respectively. Preoperative characteristics, median [IQR], included: body mass index 26.5 [22.9, 30.8], albumin 3.70 [3.2, 3.9], prealbumin 21.8 [17.6, 32.9], creatinine 0.9 [0.73, 1.20], and eGFR 83 [53, 101]. Median length of stay was 11 days [8, 15]. 30 and 90-day high grade complications were common, occurring in 33.3% and 52.7% of patients, respectively. Within 30-days of surgery, 27.8% of patients required readmission, which increased to 61.1% by 90 days after surgery. More than 1 readmission within 90 days of surgery occurred in 19.5%, while the incidence of a secondary procedure/surgery occurring over the same time period was 33.3%. CONCLUSIONS: In a cohort with a high prevalence of prior pelvic radiation therapy, the risk of high-grade complication, readmission within 90 days of surgery, and secondary procedure/surgery following colon conduit urinary diversion was high. The addition of multi-institutional data is necessary to better characterize the post-operative risks associated with colon conduit diversion in this patient population. Source of Funding: NA © 2022 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 207Issue Supplement 5May 2022Page: e430 Advertisement Copyright & Permissions© 2022 by American Urological Association Education and Research, Inc.MetricsAuthor Information Kevin Hebert More articles by this author Ryan Anderson More articles by this author Rano Matta More articles by this author Benjamin McCormick More articles by this author Jeremy Myers More articles by this author Expand All Advertisement PDF DownloadLoading ...