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Randomized Controlled Trial
. 2023 Jul;55(7):1719-1726.
doi: 10.1007/s11255-023-03609-x. Epub 2023 May 3.

Ileal conduit versus single stoma uretero-cutanoustomy after radical cystectomy in patients ≥ 75 years; which technique is better? a prospective randomized comparative study

Ahmed M Moeen  1 , Mohammad A Faragallah  2 , Mohamed A Zarzour  2 , Ahmed A Elbehairy  2 , Hosny M Behnsawy  2
Affiliations
Randomized Controlled Trial

Ileal conduit versus single stoma uretero-cutanoustomy after radical cystectomy in patients ≥ 75 years; which technique is better? a prospective randomized comparative study

Ahmed M Moeen et al. Int Urol Nephrol. 2023 Jul.

Abstract

Purpose: To compare the clinical results and patients' health-related quality of life (HR-QoL) of ileal conduit (IC) versus single stoma uretero-cutanoustomy (SSUC) after radical cystectomy in two groups of randomly selected patients ≥ 75 years.

Methods: From January 2013 to March 2018, 100 patients ≥ 75 years with muscle invasive BCa underwent RCX and cutaneous diversion. Patients were divided in two groups; group I underwent IC (50 patients) and group II underwent SSUC (50 patients). Postoperative evaluation included clinical, laboratory, radiographic and HR-QoL. The latter was performed using the Functional Assessment of Cancer Therapy-Bladder Cancer (FACT-BL) after 12 months postoperatively.

Results: Patients' characteristics were comparable between both groups. No intraoperative complications occurred. Early postoperative complications occurred in 27 patients [16 (35.5%) in group I and 11 (23.9%) in group II (p = 0.02)]. Delayed postoperative complications occurred in 26 patients [6 (13.3%) in group I and 20 (43.4%) in group II, (P = 0.002)]. No significant differences between both groups regarding the physical, social/family, emotional, functional and additional concerns scales of FACT-BL questionnaire were reported.

Conclusion: SSUC is a good alternative to IC in elderly frail patients ≥ 75 years and those with multiple comorbidities who require rapid surgery in terms of perioperative complications and HR-QoL. However, the stomal complications and the possibility of a frequent stent exchange are considered its drawbacks.

Keywords: Cutaneous ureterostomy; Elderly patients; Ileal conduit; Radical cystectomy; Urinary diversion.

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