Urology and Nephrology Research, Center, Shahid Labbafinejad, Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Urol J. 2021 Jul 6;18(6):646-651. doi: 10.22037/uj.v18i.5857.
Cutaneous ureterostomy after radical cystectomy is less preferred compared with other permanent urinary diversions due to bilateral stomas. Single umbilical stoma for bilateral ureterostomy (SUSBU) may be a choice, in this study we reviewed the outcomes of SUSBU in seventeen patients who underwent radical cystectomy.
This was a case-series study conducted from April 2016 to Dec 2017. Seventeen male patients with confirmed PT2 bladder urothelial carcinoma who were not suitable for performing conduit or orthotopic urinary diversion, including those with high-risk patients underwent single umbilical stoma for bilateral ureterostomy after radical cystectomy. All patients were prospectively followed up for 24 months ± 2 months, this study was done in a teaching center mainly by senior residents.
The mean age of patients was 68.6 ± 6.41 years. The mean length of operation time was 176.7 ± 15.1 minutes (from intubation to extubation from anesthesia). Sixteen patients were diagnosed with PT2 and one patient had a PT4 diagnosis. The decrease in hemoglobin level after surgery was 1.72 mg/dl ± 0.35 and creatinine increased by 0.15 ± 0.05 mg/dl. None of our patients had oliguria. One case developed constipation and no gas passing, with the suspicion of obstruction, underwent abdominal exploration, however, no obstruction or urine leakage was found and the patient was treated conservatively. One patient developed a fever during admission, in which atelectasis was identified as the cause. One patient underwent a second operation because of fascia dehiscence.
It seems that this technique is suitable for high-risk patients with acceptable operating time, surgical complications, and fast recovery after the operation and one ureterostomy bag instead of two one's comparing to bilateral cutaneous ureterostomy.
与其他永久性尿流改道相比，由于双侧造口，根治性膀胱切除术后的皮肤输尿管造口术不太受青睐。单脐尿管用于双侧输尿管造口术（SUSBU）可能是一种选择，在这项研究中，我们回顾了 17 例接受根治性膀胱切除术的患者行 SUSBU 的结果。
这是一项病例系列研究，于 2016 年 4 月至 2017 年 12 月进行。17 例男性患者经证实患有 PT2 膀胱尿路上皮癌，不适合进行导管或原位尿流改道术，包括那些高危患者在根治性膀胱切除术后行单脐尿管用于双侧输尿管造口术。所有患者均前瞻性随访 24 个月±2 个月，本研究主要由资深住院医师在教学中心进行。
患者的平均年龄为 68.6±6.41 岁。手术时间的平均长度为 176.7±15.1 分钟（从插管到麻醉后拔管）。16 例患者诊断为 PT2，1 例患者诊断为 PT4。术后血红蛋白水平下降 1.72mg/dl±0.35，肌酐升高 0.15±0.05mg/dl。我们的患者均无少尿。1 例出现便秘和无气通过，怀疑梗阻，行剖腹探查，但未发现梗阻或尿漏，患者保守治疗。1 例患者在住院期间发热，发现为肺不张。1 例患者因筋膜裂开而行二次手术。
对于高危患者，该技术似乎是可行的，手术时间、手术并发症可接受，术后恢复快，与双侧皮肤输尿管造口术相比，一个输尿管造口袋代替两个。
