Urology and Nephrology Hospital, Assiut University, Assiut, 71515, Egypt.
Int Urol Nephrol. 2023 Jul;55(7):1719-1726. doi: 10.1007/s11255-023-03609-x. Epub 2023 May 3.
To compare the clinical results and patients' health-related quality of life (HR-QoL) of ileal conduit (IC) versus single stoma uretero-cutanoustomy (SSUC) after radical cystectomy in two groups of randomly selected patients ≥ 75 years.
From January 2013 to March 2018, 100 patients ≥ 75 years with muscle invasive BCa underwent RCX and cutaneous diversion. Patients were divided in two groups; group I underwent IC (50 patients) and group II underwent SSUC (50 patients). Postoperative evaluation included clinical, laboratory, radiographic and HR-QoL. The latter was performed using the Functional Assessment of Cancer Therapy-Bladder Cancer (FACT-BL) after 12 months postoperatively.
Patients' characteristics were comparable between both groups. No intraoperative complications occurred. Early postoperative complications occurred in 27 patients [16 (35.5%) in group I and 11 (23.9%) in group II (p = 0.02)]. Delayed postoperative complications occurred in 26 patients [6 (13.3%) in group I and 20 (43.4%) in group II, (P = 0.002)]. No significant differences between both groups regarding the physical, social/family, emotional, functional and additional concerns scales of FACT-BL questionnaire were reported.
SSUC is a good alternative to IC in elderly frail patients ≥ 75 years and those with multiple comorbidities who require rapid surgery in terms of perioperative complications and HR-QoL. However, the stomal complications and the possibility of a frequent stent exchange are considered its drawbacks.
比较两组随机选择的年龄≥75 岁的患者行根治性膀胱切除术（RCX）后行回肠导管（IC）与单造口输尿管-皮造口术（SSUC）的临床结果和患者健康相关生活质量（HR-QoL）。
2013 年 1 月至 2018 年 3 月，100 例年龄≥75 岁、肌层浸润性膀胱癌患者行 RCX 及皮肤转流术。患者分为两组；I 组行 IC（50 例），II 组行 SSUC（50 例）。术后评估包括临床、实验室、影像学和 HR-QoL。后者在术后 12 个月采用癌症治疗功能评估-膀胱癌症（FACT-BL）进行评估。
两组患者的特征具有可比性。两组均未发生术中并发症。早期术后并发症发生在 27 例患者中[I 组 16 例（35.5%），II 组 11 例（23.9%）（P=0.02）]。26 例患者发生迟发性术后并发症[I 组 6 例（13.3%），II 组 20 例（43.4%），（P=0.002）]。FACT-BL 问卷的身体、社会/家庭、情感、功能和附加关注点量表两组间无显著差异。
对于年龄≥75 岁、身体虚弱且需要快速手术的老年患者，以及合并多种合并症的患者，SSUC 在围手术期并发症和 HR-QoL 方面是 IC 的一个较好的替代方法。然而，造口并发症和频繁更换支架的可能性被认为是其缺点。
