糖尿病和尿素水平升高可预测根治性膀胱切除术后输尿管回肠吻合口狭窄及回肠膀胱术的发生。
Diabetes and elevated urea level predict for uretero-ileal stricture after radical cystectomy and ileal conduit formation.
作者信息
Hoag Nathan, Papa Nathan, Beharry Bhawanie Koonj, Lawrentschuk Nathan, Chiu Danny, Sengupta Shomik, Bolton Damien
机构信息
Department of Urology, Austin Hospital, University of Melbourne, Australia.
出版信息
Can Urol Assoc J. 2017 Mar-Apr;11(3-4):E88-E92. doi: 10.5489/cuaj.3848. Epub 2017 Mar 16.
INTRODUCTION
Benign uretero-ileal anastomotic stricture is a significant complication following radical cystectomy and ileal conduit urinary diversion after radical cystectomy. We examined risk factors for stricture formation to predict those at greatest stricture risk.
METHODS
A retrospective chart review was conducted for patients undergoing radical cystectomy and ileal conduit diversion between 2002 and 2012. Demographic data and patient variables were analyzed to determine risk factors for uretero-ileal stricture using multivariate logistic regression.
RESULTS
Over the study period, 133 patients underwent cystectomy and ileal conduit formation, with 14 (10.5%) developing uretero-ileal anastomotic stricture. Diabetes and elevated serum urea level (defined as >7.1 mmol/L) were associated with increased risk for development of uretero-ileal stricture (odds ratio 4.31 and 4.28, respectively; p<0.05 for each).
CONCLUSIONS
In this patient cohort, diabetes and elevated serum urea level were predictive for the development of uretero-ileal anastomotic stricture. Further prospective study with larger patient samples is required.
引言
良性输尿管 - 回肠吻合口狭窄是根治性膀胱切除术后及根治性膀胱切除术后回肠代膀胱术的一种重要并发症。我们研究了狭窄形成的危险因素，以预测那些发生狭窄风险最高的患者。
方法
对2002年至2012年间接受根治性膀胱切除术及回肠代膀胱术的患者进行回顾性病历审查。分析人口统计学数据和患者变量，使用多因素逻辑回归确定输尿管 - 回肠狭窄的危险因素。
结果
在研究期间，133例患者接受了膀胱切除术及回肠代膀胱术，其中14例（10.5%）发生输尿管 - 回肠吻合口狭窄。糖尿病和血清尿素水平升高（定义为>7.1 mmol/L）与输尿管 - 回肠狭窄发生风险增加相关（比值比分别为4.31和4.28；两者p<0.05）。
结论
在该患者队列中，糖尿病和血清尿素水平升高可预测输尿管 - 回肠吻合口狭窄的发生。需要进一步开展更大样本量患者的前瞻性研究。
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