Fuschi Andrea, Al Salhi Yazan, Sequi Manfredi Bruno, Velotti Gennaro, Martoccia Alessia, Suraci Paolo Pietro, Scalzo Silvio, Asimakopoulos Anastasios, Bozzini Giorgio, Zucchi Alessandro, De Nunzio Cosimo, Carbone Antonio, Pastore Antonio Luigi
Urology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, 04100 Latina, Italy.
ICOT-Surgery, Orthopedics, Traumatology Institute, 04100 Latina, Italy.
J Clin Med. 2021 Dec 27;11(1):136. doi: 10.3390/jcm11010136.
Diversion after radical cystectomy (RC) is crucial when considering elderly subjects. Data on the quality of life (QoL) impact with different diversions is scarce. This study aims to compare complications and QoL in patients aged > 75 y.o., who underwent minimally invasive (MI) RC with Bricker intracorporeal urinary derivation and single stoma ureterocutaneostomy.
We conducted a retrospective analysis of elderly patients who underwent MIRC and intracorporeal diversion. The 78 subjects were divided into two groups: group A, ileal conduit, and group B, single stoma ureterocutaneostomy. We evaluated the bowel's recovery time and complications rate. We investigated QoL 3 and 6 months after surgery using the Stoma-QoL questionnaire.
Mean age was 77.2 in group A and 82.4 in group B. The mean ASA score and Charlson Comorbidity index were comparable between the two groups. Rates of complications were 57.6% and 37.4% in groups A and B, respectively. The mean postoperative Stoma-QoL score 3 months after surgery was 52.2 and 52.4 in groups A and B, respectively. At 6 months of follow-up the Stoma QoL mean score was 63.4, showing homogeneity between the groups.
MIRC with single stoma ureterocutaneostomy represents an alternative to ileal conduit, with comparable QoL and ostomy management 6 months after surgery, reporting fewer complications.
对于老年患者，根治性膀胱切除术后的改道至关重要。关于不同改道方式对生活质量（QoL）影响的数据稀缺。本研究旨在比较年龄>75岁、接受微创根治性膀胱切除术（MIRC）并行Bricker体内尿路改道和单孔输尿管皮肤造口术患者的并发症及生活质量。
我们对接受MIRC和体内改道的老年患者进行了回顾性分析。78名受试者分为两组：A组为回肠膀胱术，B组为单孔输尿管皮肤造口术。我们评估了肠道恢复时间和并发症发生率。我们使用造口生活质量问卷在术后3个月和6个月调查生活质量。
A组平均年龄为77.2岁，B组为82.4岁。两组间平均美国麻醉医师协会（ASA）评分和查尔森合并症指数相当。A组和B组的并发症发生率分别为57.6%和37.4%。术后3个月，A组和B组的术后造口生活质量平均评分分别为52.2和52.4。随访6个月时，造口生活质量平均评分为63.4，两组间表现出一致性。
MIRC并行单孔输尿管皮肤造口术是回肠膀胱术的一种替代方案，术后6个月生活质量和造口管理相当，并发症更少。
