scholarly journals Cutaneous ureterostomy or ileal conduit urinary diversion: Can we spare the bowel following radical cystectomy in patients with solitary functioning kidney?

2020 ◽  
Vol 21 ◽  
pp. S213
Author(s):  
B. Nayak ◽  
S. Saini ◽  
P. Singh ◽  
R. Nayyar ◽  
A. Seth
Keyword(s):  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Solitary Functioning Kidney ◽  
Functioning Kidney ◽  
Cutaneous Ureterostomy

scholarly journals Quality of Life and Renal Functional Status In Patients With Cutaneous Ureterostomy and Ileal Conduit Urinary Diversion after Radical Cystectomy

2020 ◽  
Vol 23 (2) ◽  
pp. 142-150
Author(s):  
Subrata Deb ◽  
Md Golam Mowla Chowdhury ◽  
Mohammad Shafiqur Rahman ◽  
Mohammad Salahuddin Faruque ◽  
Ashraful Islam ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Renal Function ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Ileal Conduit ◽  
Group A ◽  
Muscle Invasive ◽  
Group B ◽  
Cutaneous Ureterostomy

Introduction: Radical cystoprostetectomy in male patients and anterior pelvic exenteration in female patients coupled with en-block pelvic lymphadenectomy and urinary reconstruction or diversion remains the gold standard surgical approach to muscle invasive bladder cancer in the absence of metastatic disease. In Bangladesh, commonly performed urinary diversions are Cutaneous ureterostomy and Ileal conduit. Types of urinary diversion have a great impact on different aspects of quality of life (QoL) as well as post -operative renal function. Aims and Objectives: This study was designed to compare the Quality of Life and Renal Function in between Cutaneous ureterostomy and Ileal conduit urinary diversion after radical cystectomy. Methodology: This was a hospital based Quasi Experimental study in which patients were selected by purposive sampling and, conducted from July, 2017 to September, 2018 in the department of Urology Bangabandhu Sheikh Mujib Medical University. This study was performed among the patients with muscle invasive bladder cancer treated by radical cystectomy with cutaneous ureterostomy or Ileal conduit fulfilling the exclusion and inclusion criteria. Total 34 patients were taken for the study, among them 17 for cutaneous ureterostomy and, 17 for Ileal Conduit Group. Quality of Life was assessed through EORTC-QLQ-C30 questionnaire both pre and post operatively (3 months after operation). Renal function was assessed before and 1st POD, 7thPOD, one month and three months after operation by measuring eGFR. Result: Mean age of the patients was 59.00 ± 8.60 years and 53.35 ± 8.43years in group- A (Cutaneous ureterostomy) and group-B (Ileal conduit) respectively. Three months after operation, overall QoL in all scales were improved in both group but, more improvements were noted in group-B than group-A which were statistically significant (p<0.05). The mean pre-operative eGFR was significantly lower in group-A than group-B (p<0.001). Three months after operation, statistically significant differences in eGFR, were observed within, and in between two groups (p<0.05). Percentage of eGFR changed (renal function deterioration) were significantly more in group-A than group-B (p=0.001). Conclusion: Quality of life, after radical cystectomy with ileal conduit is better than cutaneous ureterostomy and, post- operative renal function deterioration significantly less in ileal conduit group than cutaneous ureterostomy group. So, ileal conduit is an appropriate option of urinary diversion for the patient those who permit prolong operative procedure. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.142-150

scholarly journals Short- and Long-Term Evaluation of Renal Function after Radical Cystectomy and Cutaneous Ureterostomy in High-Risk Patients

2020 ◽  
Vol 9 (7) ◽  
pp. 2191
Author(s):  
Massimiliano Creta ◽  
Ferdinando Fusco ◽  
Roberto La Rocca ◽  
Marco Capece ◽  
Giuseppe Celentano ◽  
...  
Keyword(s):  
Renal Function ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Kidney Injury ◽  
Risk Patients ◽  
Term Evaluation ◽  
Gfr Decline ◽  
American Society ◽  
American Society Of Anesthesiologists ◽  
Cutaneous Ureterostomy

Deterioration of renal function has been reported after radical cystectomy (RC) with urinary diversion. We investigated renal function changes in elderly bladder cancer (BCa) patients who underwent RC with cutaneous ureterostomy (CU) urinary diversion. We performed a retrospective, observational study. BCa patients aged ≥75 with an American Society of Anesthesiologists (ASA) class greater than II were included. Glomerular filtration rate (GFR) was the main outcome measure. GFR values were recorded preoperatively, at discharge, at 6-month follow-up, and yearly up to 60 months. A total of 70 patients with a median age of 78.0 years were identified. Median preoperative GFR was 74.3 mL/min/1.73 m2 and declined significantly to 54.6 mL/min/1.73 m2 after 6 months (p < 0.001). A gradual GFR decline was observed thereafter, reaching a median value of 46.2 after 60 months. Preoperative GFR and acute kidney injury were significant predictors of fast deterioration of GFR and of 25% deterioration of GFR after 12 months. Elderly BCa patients with high comorbidity rates undergoing RC with CU should be carefully informed about the risk of GFR deterioration and the need for adequate monitoring.

Retrosigmoid Versus Traditional Ileal Conduit for Urinary Diversion After Radical Cystectomy

2019 ◽  
Vol 75 (2) ◽  
pp. 294-299 ◽  
Author(s):  
Vincenzo Ficarra ◽  
Gianluca Giannarini ◽  
Alessandro Crestani ◽  
Vito Palumbo ◽  
Marta Rossanese ◽  
...  
Keyword(s):  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Ileal Conduit

scholarly journals Comparison of a Significant Decline in the Glomerular Filtration Rate between Ileal Conduit and Ileal Neobladder Urinary Diversions after Radical Cystectomy: A Propensity Score-Matched Analysis

2020 ◽  
Vol 9 (7) ◽  
pp. 2236 ◽  
Author(s):  
Jihion Yu ◽  
Bumsik Hong ◽  
Jun-Young Park ◽  
Yongsoo Lee ◽  
Jai-Hyun Hwang ◽  
...  
Keyword(s):  
Propensity Score ◽  
Radical Cystectomy ◽  
Urinary Diversion ◽  
Filtration Rate ◽  
Ileal Conduit ◽  
Significant Decline ◽  
Ileal Neobladder ◽  
Renal Function Impairment ◽  
Function Impairment ◽  
Gfr Decline

Urinary diversion after radical cystectomy is associated with a risk of renal function impairment. A significant decline in the glomerular filtration rate (GFR) (i.e., a ≥30% decline in baseline GFR after 12 months) is associated with long-term renal function impairment. We compared the significant GFR decline between ileal conduit and ileal neobladder urinary diversions 12 months after radical cystectomy. We retrospectively included radical cystectomy patients. Propensity score-matched analysis was performed. The primary outcome was the incidence of a significant GFR decline in ileal conduit urinary diversion (ileal conduit group) and ileal neobladder urinary diversion (ileal neobladder group) 12 months after radical cystectomy. The secondary outcomes were the change of GFR and the incidence of end-stage renal disease (ESRD) in the two groups. After propensity score matching, the ileal conduit and neobladder groups had 117 patients each. The incidence of a significant GFR decline was not significantly different between ileal conduit and ileal neobladder groups (12.0% vs. 13.7%, p = 0.845). The change of GFR and ESRD incidence were not significantly different between the two groups (−8.4% vs. −9.7%, p = 0.480; 4.3% vs. 5.1%, p > 0.999, respectively). These results can provide important information on appropriate selection of the urinary diversion type in radical cystectomy.

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