MP32-02 SURGICAL TECHNIQUE OF EXTRAPERITONEALIZING ILEAL CONDUIT DECREASE PARASTOMAL HERNIA COMPLICATION: A SINGLE-CENTER, PROSPECTIVE, RANDOMIZED, CONTROLLED CLINICAL TRIAL

Abstract

You have accessJournal of UrologyCME1 Apr 2023MP32-02 SURGICAL TECHNIQUE OF EXTRAPERITONEALIZING ILEAL CONDUIT DECREASE PARASTOMAL HERNIA COMPLICATION: A SINGLE-CENTER, PROSPECTIVE, RANDOMIZED, CONTROLLED CLINICAL TRIAL Zhaohui Zhou, Zhiyong Li, Zhiling Zhang, Kai Yao, Huali Ma, Shengjie Guo, Pei Dong, Yunlin Ye, Fangjian Zhou, and Zhuowei Liu Zhaohui ZhouZhaohui Zhou More articles by this author , Zhiyong LiZhiyong Li More articles by this author , Zhiling ZhangZhiling Zhang More articles by this author , Kai YaoKai Yao More articles by this author , Huali MaHuali Ma More articles by this author , Shengjie GuoShengjie Guo More articles by this author , Pei DongPei Dong More articles by this author , Yunlin YeYunlin Ye More articles by this author , Fangjian ZhouFangjian Zhou More articles by this author , and Zhuowei LiuZhuowei Liu More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003265.02AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Parastomal hernia (PSH) is a common complication in patients receiving ileal conduit urinary diversion after radical cystectomy. To validate our previous finding that extraperitonealization of ileal conduit (modified ileal conduit) decreases incidence of PSH after ileal conduit diversion. METHODS: This is a single-center, randomized controlled clinical trial (clinicaltrials.gov, NCT03822234). Between January, 2019 and March, 2020, 104 consecutive patients undergoing radical cystectomy at Sun Yat-sen University Cancer Center were randomized 1:1 to receive either modified ileal conduit (n=52) or conventional ileal conduit (n=52). One group received extraperitonealization of ileal conduit, the other received conventional ileal conduit. Primary endpoint was incidence of radiological PSH at 24 months post surgery. Secondary endpoints were incidence of stomal complications (retraction, stenosis, and prolapse) at 24 months. Other complications related to surgery were also recorded. RESULTS: Incidence of radiological PSH was lower in modified ileal conduit patients than in conventional ileal conduit patients (11.5% [6/52] vs. 28.8% [15/52]; p=0.028) after a median follow-up of 32 months, corresponding to a hazard ratio of 0.375 (95% CI: 0.146-0.967, p=0.043) in the modified conduit group. No stomal retraction, stenosis or prolapse complications occurred. Median operating time was comparable between the groups. Early surgery-related complications were less in modified conduit patients; late complications were similar in the two groups. CONCLUSIONS: The results support our previous finding that extraperitonealization of ileal conduit is effective for reducing risk of PSH in ileal conduit diversion patients. Further multicenter controlled clinical trials on large samples (including obese patients) are needed. Source of Funding: Without source of funding © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e439 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Zhaohui Zhou More articles by this author Zhiyong Li More articles by this author Zhiling Zhang More articles by this author Kai Yao More articles by this author Huali Ma More articles by this author Shengjie Guo More articles by this author Pei Dong More articles by this author Yunlin Ye More articles by this author Fangjian Zhou More articles by this author Zhuowei Liu More articles by this author Expand All Advertisement PDF downloadLoading ...