PD59-11 URETERO-ENTERIC STRICTURES AFTER ROBOT ASSISTED RADICAL CYSTECTOMY: PREVALENCE AND PREDICTORS

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive V (PD59)1 Sep 2021PD59-11 URETERO-ENTERIC STRICTURES AFTER ROBOT ASSISTED RADICAL CYSTECTOMY: PREVALENCE AND PREDICTORS Umar Iqbal, Holly Houenstein, Zhe Jing, Nighat Sofi, Gaybrielle James, Ahmed S. Elsayed, Qiang Li, Ahmed A. Hussein, and Khurshid A. Guru Umar Iqbal Umar Iqbal More articles by this author , Holly HouensteinHolly Houenstein More articles by this author , Zhe JingZhe Jing More articles by this author , Nighat SofiNighat Sofi More articles by this author , Gaybrielle JamesGaybrielle James More articles by this author , Ahmed S. ElsayedAhmed S. Elsayed More articles by this author , Qiang LiQiang Li More articles by this author , Ahmed A. HusseinAhmed A. Hussein More articles by this author , and Khurshid A. GuruKhurshid A. Guru More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002096.11AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteroenteric strictures (UES) are a common cause of reoperations after robot assisted radical cystectomy (RARC). We sought to evaluate the prevalence, predictors, management and trend over time for strictures after RARC. METHODS: We reviewed our departmental quality assurance database for RARC (2005-2020). Patients who developed UES were identified. Data was analyzed for demographics and perioperative variables. UES were described in terms of timing, laterality and management. Multivariable analysis was used to identify variables associated with UES. Kaplan Meir curves were used to depict time to UES. RESULTS: Out of 671 patients undergoing RARC, 101 (15%) developed UES. They occurred at a rate of 9%, 14% and 18% at 6 months, 1 year and 3 years after RARC, respectively (Figure). Strictures were on the right in 31%, on the left in 49 % and bilateral in 20%. Initial management was endoscopic in 65% and percutaneous in 35%. Eventually, reimplantation was performed in 44% of the patients (open 13% and robotic 31%). Patients with UES had higher body mass index (30±6 vs 29±6, p=0.03), lower eGFR (ml/min) at 90 days (61 vs 72, p=0.02), higher rate of acute kidney injury within 90 days (22% vs 12 %, p=0.01), higher rate of urinary tract infections (UTI) within 90 days (54% vs 36%, p=0.01) recurrent UTI within 90 days (13% vs 4 %, p <0.01) (Table). Congestive heart failure (OR 2.83, CI 1.12 -7.18, p=0.03) and neoadjuvant chemotherapy (OR 1.76, CI 1.12 – 2.77, p=0.01) were associated with stricture formation. CONCLUSIONS: UES occurred in 15% of patients after RARC and required reimplantation in almost half of cases. History of congestive heart failure and neoadjuvant chemotherapy were associated with UES. Source of Funding: Roswell Park Alliance Foundation © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e1058-e1059 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Umar Iqbal More articles by this author Holly Houenstein More articles by this author Zhe Jing More articles by this author Nighat Sofi More articles by this author Gaybrielle James More articles by this author Ahmed S. Elsayed More articles by this author Qiang Li More articles by this author Ahmed A. Hussein More articles by this author Khurshid A. Guru More articles by this author Expand All Advertisement Loading ...