Ureteroileal anastomosis-associated complications of radical cystectomy with ileal conduit in bladder cancer treatment

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Abstract

Background. Radical cystectomy remains the gold standard of bladder cancer treatment for both muscle invasive form and high-risk patients. However, despite the patients’ high quality of life after radical cystectomy, formation of ureteroileal anastomoses (UIA) is still associated with a number of serious complications at various times in the postoperative period.

Aim. To evaluate the effectiveness of an original technique of UIA formation in the context of development of postoperative complications.

Materials and methods. At the N.N. Petrov National Medical Research Center of Oncology between January 2012 and October 2023, 465 radical cystectomies with ileal conduit were performed. In retrospective analysis, patients were divided into two groups: group 1 (n = 285) with the conventional technique for forming UIA, group 2 (n = 180) with a modified technique. Clinical and demographic characteristics of the groups were compared using t-test and χ2-test. Multivariate logistic regression analysis was performed to determine the likelihood of complications associated with UIA.

Results. Both groups were matched by clinical and demographic characteristics. The overall rate of complications associated with UIA was slightly lower in group 2 than in the conventional technique group (15 % vs. 16 %; p <0.001). Late complications associated with UIA were observed significantly less in the modification group (2.7 % vs. 4.2 %; p <0.001), and in group 2 repeat surgical interventions were required significantly less often. In multivariate analysis, the modified technique group was significantly less likely to develop UIA-associated complications than the conventional technique group (odds ratio 0.123; 95 % confidence interval 0.06–0.22 vs. odds ratio 0.179; 95 % confidence interval 0.12–0.27; p <0.001).

Conclusion. The presented modified technique of UIA formation can be quite effective in reducing the risk of developing UIA-associated complications.

About the authors

D. I. Rumiantseva

N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia

Author for correspondence.
Email: shinigami.rdi@gmail.com
ORCID iD: 0000-0002-8067-9150

Darya I. Rumiantseva - Oncologist, Postgraduate, Department of General Oncology and Urology

68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

E. M. Mamizhev

N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia

Email: shinigami.rdi@gmail.com
ORCID iD: 0000-0001-6883-777X

PhD (Med.), Oncologist, Department of Urologic Oncology

68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

N. F. Krotov

N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia

Email: shinigami.rdi@gmail.com
ORCID iD: 0000-0002-5590-8804

DoS (Med.), Oncologist, Senior Researcher, Associate Professor, Head of Research Division of Surgical Oncology

68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

N. А. Shchekuteev

N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia

Email: shinigami.rdi@gmail.com
ORCID iD: 0000-0001-9625-3907

Oncologist, Department of Urologic Oncology

68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

M. E. Karasev

N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia

Email: shinigami.rdi@gmail.com
ORCID iD: 0009-0006-7294-0263

Resident, Department of Urologic Oncology

68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

D. P. Semeyko

N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia

Email: shinigami.rdi@gmail.com
ORCID iD: 0000-0003-1962-3630

Urologist, Department of Urologic Oncology

68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

Ya. P. Bashmakova

The University of British Columbia Okanagan

Email: shinigami.rdi@gmail.com
ORCID iD: 0000-0003-0872-7784

Master of Arts, research assistant 

Kelowna

Canada

A. K Nosov

N.N. Petrov National Medical Research Center of Oncology, Ministry of Health of Russia

ORCID iD: 0000-0003-3850-7109

68 Leningradskaya St., Pesochnyy, Saint Petersburg 197758

Russian Federation

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