|
Back to 2011 Program
Uteral Stent Placement at the Time of Urinary Diversion Decreases Post-Operative Morbidity
Jeffrey K Mullins1, Thomas J Guzzo2, Mark W Ball1, Phillip M Pierorazio1, John B Eifler1, Thomas W Jarrett3, Mark P Schoenberg1, Trinity J Bivalacqua1
1Johns Hopkins Medical Institutions, Baltimore, MD;2University of Pennsylvania, Philadelphia, PA;3The George Washington University, Wasington, DC
Introduction:
The Objective of this study is to determine the impact of stenting the ureteroenteric anastomosis on post-operative stricture rate and gastrointestinal recovery in continent and non-continent urinary diversion after radical cystectomy.
Materials and Methods:
We retrospectively reviewed the clinical and pathologic data on 192 consecutive patients who underwent a radical cystectomy and bilateral pelvic lymphadenctomy from 2003-2007. Patients received either continent (orthotopic ileal neobladder, catheterizable reservoir) or non-continent (ileal conduit) urinary diversion with or without stent placement through the ureteroenteric anastomosis. Stricture rate, gastrointestinal recovery (ileus), length of hospital stay, and stricture were analyzed. Study end points were compared between four groups - stented and non-stented continent and stented and non-stented non-continent diversion.
Results:
Overall, 36% patients were stented and 64% were non-stented at time of urinary diversion. Mean follow up was 25 months. The total ureteral stricture rate was 9.9%. There was no statistically significant difference in stricture rate (p=0.11) or length of hospital stay (p=0.081) in stented patients compared to non-stented patients. There was a significantly (p =0.014) greater ileus rate in patients who were not stented in both continent and non-continent urinary diversion. Endoscopic management of strictures was attempted in 42.1% of cases and was successful in 12.5% of cases.
Conclusions:
Stenting of the ureteroenteric anastomosis in both continent and non-continent urinary diversion has no effect on post-operative stricture rate but is associated with lower rates of post-operative ileus.
Back to 2011 Program
|
