MP56-18 STENT VS STENT-LESS ILEAL CONDUITS AFTER RADICAL CYSTECTOMIES: IS THERE DIFFERENCE IN EARLY POSTOPERATIVE OUTCOMES

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You have accessJournal of UrologyCME1 Apr 2023MP56-18 STENT VS STENT-LESS ILEAL CONDUITS AFTER RADICAL CYSTECTOMIES: IS THERE DIFFERENCE IN EARLY POSTOPERATIVE OUTCOMES Rishabh Simhal, Yash Shah, Kerith Wang, Daniel Simon, James Mark, Zachary Prebay, Costas Lallas, Leonard Gomella, and Mihir Shah Rishabh SimhalRishabh Simhal More articles by this author , Yash ShahYash Shah More articles by this author , Kerith WangKerith Wang More articles by this author , Daniel SimonDaniel Simon More articles by this author , James MarkJames Mark More articles by this author , Zachary PrebayZachary Prebay More articles by this author , Costas LallasCostas Lallas More articles by this author , Leonard GomellaLeonard Gomella More articles by this author , and Mihir ShahMihir Shah More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003309.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Placing stents at the ureteroileal anastomosis for radical cystectomy with ileal conduit (RCIC) diversion has been common practice for the vast majority of urologists. Recently, the practice has been called into question, as some institutions have shifted to not stenting their ileal conduits for patient comfort and convenience. In this study, we aim to investigate the difference in 30-day outcomes between patients who did and did not receive ureteroileal stents after RCIC. METHODS: RCs performed between 2019-2020 were identified in NSQIP and the corresponding cystectomy-targeted database. Baseline demographics, comorbidities, and operative parameters were compared via Pearson’s chi-square and t-tests between stented and stent-less RCICs. Outcomes of interest included rates of urinary tract infections (UTIs), acute kidney injury (AKI), renal failure requiring dialysis, anastomotic leaks, ureteral obstruction, ureteral fistula formation, need for reoperation, and 30-day hospital readmissions. Outcomes were compared using Pearson’s chi-square. All statistical tests were two tailed, p<0.05 considered significant. RESULTS: 3,865 RCICs were identified, of which 446 (11.5%) were stent-less. There was no difference in baseline demographics, comorbidities, or operative parameters between the stented and stent-less group, with the notable exceptions that significantly more stent-less patients had robotic-assisted instead of open RCs compared to the stented group (33% vs 21%, p<0.001), and significantly more stent-less patients were preoperatively on dialysis compared to the stented group (4.9% vs 0.5%, p<0.001). There was no significant difference in 30-day rates of UTIs, AKIs, renal failure, anastomotic leaks, ureteral obstruction, ureteral fistula formation, need for reoperation, and readmissions between the stented and stent-less cohorts. CONCLUSIONS: Stent-less ileal conduits have recently emerged in popularity. This study represents the largest multi-institutional analysis comparing outcomes between traditionally stented and stent-less RCICs, and shows that there is no significant difference in outcomes. This study shows no difference in significant perioperative complications in patients without stents compared to those with stents. Therefore this needs to be investigated further given the overall cost, patient discomfort and concern for stent related infectious complications. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e782 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Rishabh Simhal More articles by this author Yash Shah More articles by this author Kerith Wang More articles by this author Daniel Simon More articles by this author James Mark More articles by this author Zachary Prebay More articles by this author Costas Lallas More articles by this author Leonard Gomella More articles by this author Mihir Shah More articles by this author Expand All Advertisement PDF downloadLoading ...