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.
Journal of clinical medicine. 2021 Dec 27*** epublish ***
Andrea Fuschi, Yazan Al Salhi, Manfredi Bruno Sequi, Gennaro Velotti, Alessia Martoccia, Paolo Pietro Suraci, Silvio Scalzo, Anastasios Asimakopoulos, Giorgio Bozzini, Alessandro Zucchi, Cosimo De Nunzio, Antonio Carbone, Antonio Luigi Pastore
Urology Unit, Department of Medico-Surgical Sciences and Biotechnologies, Faculty of Pharmacy and Medicine, Sapienza University of Rome, 04100 Latina, Italy., Urology Unit, Tor Vergata University, 00100 Rome, Italy., ASST Lariana, 22100 Como, Italy., Department of Urology, University of Pisa, 56121 Pisa, Italy., Department of Urology, Faculty of Medicine and Psychiatry, Sant'Andrea Hospital, 00100 Rome, Italy.