Wei H, Wang M, Wasilijiang W, Zhou X, Cui L, Song L, Xing N, Niu Y. Propensity score-matched analysis for ileal conduit and orthotopic neobladder intracorporeally accomplished following laparoscopic radical cystectomy.
Asian J Surg 2021;
45:987-992. [PMID:
34509357 DOI:
10.1016/j.asjsur.2021.08.022]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/06/2021] [Accepted: 08/06/2021] [Indexed: 11/18/2022] Open
Abstract
PURPOSE
To compare perioperative results of intracorporeal ileal conduit (ICIC) and intracorporeal orthotopic neobladder (ICONB) following laparoscopic radical cystectomy.
MATERIALS AND METHODS
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.
RESULTS
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).
CONCLUSIONS
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.
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