The effect of urinary diversion on renal function after cystectomy for bladder cancer: comparison between ileal conduit, orthotopic ileal neobladder, and heterotopic ileocecal pouch
- 08.11.2022
- Original Article
Erschienen in:
- Verfasst von
- Nikolaos Pyrgidis
- Ioannis Sokolakis
- Gena Haltmair
- Georgios Hatzichristodoulou
- Erschienen in
- World Journal of Urology | Ausgabe 12/2022
Abstract
Purpose
To explore the impact of ileal conduit (IC), orthotopic ileal neobladder, and MAINZ Pouch I on renal function (RF) over time.
Methods
We performed a retrospective, cohort study including consecutive patients who underwent open radical cystectomy due to bladder cancer from November 2013 to June 2022. RF deterioration was calculated based on the estimated glomerular filtration rate (eGFR) through the CKD-EPI creatinine equation. A linear mixed-effects model was constructed, adjusting for multiple risk factors. The probability of achieving an eGFR reduction greater than 25% compared to baseline among different urinary diversion techniques was assessed using a Kaplan–Meier curve.
Results
Overall, 107 patients received IC, 28 neobladder, and 20 MAINZ Pouch I. Those receiving IC were older and displayed more comorbidities. At follow-up, eGFR was lower by 0.09 mL/min/1.73m2 (confidence interval − 5.87 to 5.69, p = 0.975) in patients receiving neobladder compared to those receiving IC. Similarly, eGFR was higher by 4.64 mL/min/1.73m2 (confidence interval − 1.57 to 10.85, p = 0.143) in patients receiving pouch compared to those receiving IC. Accordingly, patients with higher preoperative eGFR (p < 0.001), lower age (p = 0.048), non-T4 histological tumor (p = 0.027) and absence of septicemia at follow-up (p = 0.002) presented higher eGFR values at follow-up. The three UD techniques did not differ significantly in the time-to-event analysis (log-rank test = 0.29).
Conclusions
A substantial proportion of patients undergoing urinary diversion with IC, orthotopic ileal neobladder, or MAINZ Pouch I develop RF deterioration at follow-up. No significant differences were observed among the three UD techniques in terms of eGFR decline in the long-term.
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- Titel
- The effect of urinary diversion on renal function after cystectomy for bladder cancer: comparison between ileal conduit, orthotopic ileal neobladder, and heterotopic ileocecal pouch
- Verfasst von
-
Nikolaos Pyrgidis
Ioannis Sokolakis
Gena Haltmair
Georgios Hatzichristodoulou
- Publikationsdatum
- 08.11.2022
- Verlag
- Springer Berlin Heidelberg
- Erschienen in
-
World Journal of Urology / Ausgabe 12/2022
Print ISSN: 0724-4983
Elektronische ISSN: 1433-8726 - DOI
- https://doi.org/10.1007/s00345-022-04211-z
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