Celen Sinan, Ozlulerden Yusuf, Baser Aykut, Alkış Okan, Kucuker Kursat, Duran Mesut Berkan
Urology, Pamukkale University School of Medicine, Denizli, TUR.
Urology, Bandirma Onyedi Eylul University School of Medicine, Balikesir, TUR.
Cureus. 2024 Mar 31;16(3):e57306. doi: 10.7759/cureus.57306. eCollection 2024 Mar.
This study's objective is to assess the effect of preoperative factors on postoperative hydroureteronephrosis (HUN) after radical cystectomy (RC) in patients with bladder cancer (BC).
Patients who underwent RC for BC between January 2019 and November 2022 and had unilateral or bilateral postoperative HUN were retrospectively analyzed. Patients without preoperative HUN but with postoperative HUN constituted the patient group, while patients without both preoperative and postoperative HUN constituted the control group, and they were compared with each other.
Neoadjuvant chemotherapy (NAC) and postoperative metastasis were positively correlated with postoperative HUN ( = 0.238, = 0.007, and = 0.203, = 0.021, respectively). Multivariate logistic regression analysis showed that the postoperative HUN was significantly associated with NAC (= 0.048; Exp() = 6.896, 95% confidence interval [CI] 1.02-46.9) but not associated with the presence of metastasis ( = 0.054). Moreover, NAC increased the possibility of undergoing revision surgery ( = 0.002; Exp() = 26.9, 95% CI 3.2-225).
NAC is an independent factor for impaired anastomotic healing, increased postoperative HUN, and the need for revision surgery in patients with BC.
本研究旨在评估术前因素对膀胱癌（BC）患者根治性膀胱切除术（RC）术后输尿管肾积水（HUN）的影响。
回顾性分析2019年1月至2022年11月期间因BC接受RC且术后出现单侧或双侧HUN的患者。术前无HUN但术后出现HUN的患者构成患者组，术前和术后均无HUN的患者构成对照组，对两组进行比较。
新辅助化疗（NAC）和术后转移与术后HUN呈正相关（分别为 = 0.238， = 0.007，以及 = 0.203， = 0.021）。多因素逻辑回归分析显示，术后HUN与NAC显著相关（ = 0.048；Exp() = 6.896，95%置信区间[CI] 1.02 - 46.9），但与转移的存在无关（ = 0.054）。此外，NAC增加了进行修复手术的可能性（ = 0.002；Exp() = 26.9，95% CI 3.2 - 225）。
NAC是BC患者吻合口愈合受损、术后HUN增加以及需要进行修复手术的独立因素。
