Propensity score-matched analysis for ileal conduit and orthotopic neobladder intracorporeally accomplished following laparoscopic radical cystectomy

Abstract

To compare perioperative results of intracorporeal ileal conduit (ICIC) and intracorporeal orthotopic neobladder (ICONB) following laparoscopic radical cystectomy. A total of 51 ICIC patients and 32 ICONB patients were included. Propensity score matching was performed based on: age, body mass index, gender, age-adjusted Charlson comorbidity index, history of neoadjuvant chemotherapy, history of abdominal surgery, history of smoking and enhanced recovery protocols. Primary outcomes were length of stay and 30-day complications. Secondary outcomes were operative time and estimated blood loss. ICONB was more likely to be performed in younger patients (P<0.001). Other baseline characteristics in the 2 groups were similar (P>0.05). ICIC showed shorter length of stay (11 days vs. 14 days, P=0.031) and faster pelvic drainage tube removal (6 days vs. 9 days, P=0.014). Operative time, estimated blood loss, 30-day complications were similar in the 2 groups (P>0.05). However, postoperative fever was significantly lower in ICIC group (19.6% vs. 62.5%, P<0.001). After propensity score matching, ICIC still showed shorter length of stay (10 days vs. 15 days, P=0.002) and less postoperative fever (15% vs. 65%, P=0.003). In multivariable analysis, ICONB was independently associated with length of stay≥14 days and postoperative fever both before and after propensity score matching (P<0.05). In our research, ICONB was more likely to be performed in younger patients. ICIC and ICONB showed no difference on 30-day complications, operative time and estimated blood loss. ICIC group showed shorter length of stay, faster pelvic drainage tube removal and less postoperative fever.