PD35-03 RISK OF URETEROILEAL ANASTOMOTIC STRICTURES WITH THE RETROSIGMOID ILEAL CONDUIT AFTER OPEN RADICAL CYSTECTOMY: MID-TERM FOLLOW-UP RESULTS OF A PROSPECTIVE TWO-CENTRE STUDY

Abstract

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion I (PD35)1 Sep 2021PD35-03 RISK OF URETEROILEAL ANASTOMOTIC STRICTURES WITH THE RETROSIGMOID ILEAL CONDUIT AFTER OPEN RADICAL CYSTECTOMY: MID-TERM FOLLOW-UP RESULTS OF A PROSPECTIVE TWO-CENTRE STUDY Gianluca Giannarini, Alessandro Crestani, Marta Rossanese, Giuseppe Alario, Giuseppe Mucciardi, Claudio Valotto, and Vincenzo Ficarra Gianluca GiannariniGianluca Giannarini More articles by this author , Alessandro CrestaniAlessandro Crestani More articles by this author , Marta RossaneseMarta Rossanese More articles by this author , Giuseppe AlarioGiuseppe Alario More articles by this author , Giuseppe MucciardiGiuseppe Mucciardi More articles by this author , Claudio ValottoClaudio Valotto More articles by this author , and Vincenzo FicarraVincenzo Ficarra More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002039.03AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: We have previously compared the perioperative and short-term follow-up results of retrosigmoid ileal conduit without contralateral transposition of the left ureter versus traditional ileal conduit after radical cystectomy (RC) in a single-surgeon series, and observed a significantly reduced ureteroileal anastomotic stricture (UAS) rate with the former. In this study, we assessed perioperative outcomes, complications and, in particular, UAS rate at a longer follow-up in a larger, two-centre, two-surgeon cohort of patients receiving retrosigmoid ileal conduit after RC. METHODS: Between 03/2016 and 06/2020, 97 consecutive patients (median age 75 years) underwent open RC and retrosigmoid conduit using a 20-cm long ileal segment at two academic centres within a prospective study. Two expert high-volume surgeons performed all cases. Ureteric catheters were removed on postoperative day 7 and 8. All patients were followed with ultrasound examination of abdomen/pelvis at 3 months, CT of abdomen/pelvis at 6 and 12 months after surgery, and then CT yearly for 5 years or when clinically indicated. UAS was defined as any upper urinary tract dilatation requiring endourological or surgical management. Operating room time, estimated blood loss, and 90-day postoperative complications classified according to the Dindo-Clavien system were assessed. In particular, UAS rate and side was evaluated. RESULTS: Median operating room time was 245 (interquartile range [IQR] 215-290) min, median estimated blood loss was 350 (IQR 300-500) ml, and blood transfusions were given to 15 (15.5%) cases. No intraoperative complications were observed. Ninety-day postoperative complications were observed in 33 (34%) patients, being major (grade 3-5) in 19 (19.6%) cases. Two patients died of early postoperative complications. No single case of ureteroileal anastomotic leakage or any urinary fistula was observed. At a median follow-up of 25 (IQR 14-40) months, only one case (1%) of UAS was observed, involving the right ureter of an obstructed kidney and requiring an open ureteroileal reimplantation. CONCLUSIONS: We showed that retrosigmoid ileal conduit is a safe and valid option in patients undergoing non-continent urinary diversion after RC. Of note, UAS rate is very low with this technique, mainly due to the preservation of naïve location of, and blood supply to, the left ureter without transposition to the contralateral side. Further studies are warranted to confirm our very good results. Source of Funding: None © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e589-e589 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Gianluca Giannarini More articles by this author Alessandro Crestani More articles by this author Marta Rossanese More articles by this author Giuseppe Alario More articles by this author Giuseppe Mucciardi More articles by this author Claudio Valotto More articles by this author Vincenzo Ficarra More articles by this author Expand All Advertisement Loading ...