Evaluation of the improved tubeless cutaneous ureterostomy technique following radical cystectomy in cases of invasive bladder cancer complicated by peritoneal metastasis

Abstract

Radical cystectomy, as the most common surgical treatment for patients with invasive bladder cancer (IBC) complicated by peritoneal metastasis, is usually accompanied by a urinary diversion procedure. In this study, we evaluated the improved tubeless cutaneous ureterostomy technique by comparing the resulting clinical effects with either a traditional ureterostomy and an ileal conduit urinary diversion. Clinical data from 85 patients who underwent 1 of the 3 procedures between April 2012 and April 2015 were analyzed retrospectively. In total, 30 patients underwent improved tubeless cutaneous ureterostomy, 28 patients underwent a traditional cutaneous ureterostomy and 27 underwent an ileal conduit urinary diversion following radical cystectomy. The incidence of complications, including stoma infection, nipple atrophy, terminal necrosis, urine leakage, external orifice stenosis, uronephrosis and ureterectasia in the group of patients treated with the improved tubeless ureterostomy technique was significantly lower than that of the patients in the other 2 groups, and the difference was statistically significant (P<0.05). In addition, the duration of the surgery, intra-operative bleeding, the duration of the hospitalization period and the time to extubation in the patients treated with the improved tubeless ureterostomy technique were significantly decreased (P<0.05) compared with the patients in the other 2 groups. Finally, the health-related quality of life of the patients treated with the improved tubeless ureterostomy technique was significantly higher (P<0.05) than that of the patients in the other 2 groups. The findings of our study demonstrated that the use of the improved tubeless cutaneous ureterostomy technique following radical cystectomy in patients with IBC complicated by peritoneal metastasis resulted in improved clinical effects. Thus, improved tubeless cutaneous ureterostomy may be a promising alternative for enhancing the quality of life of patients with IBC.

The effect of body mass index on quality of life in modified single stoma cutaneous ureterostomy or ileal conduit after radical cystectomy

“…Inclusion criteria 18 : ①18–80 years old; normal ureteral structure and function as indicated by preoperative imaging; normal renal function as indicated by preoperative laboratory examinations; ② postoperative pathological report indicating the diagnosis of confined BCa without distant metastasis; ③0–1 points of ECOG score within 1 year after surgery; ④adequate educational level of to understand and complete the questionnaires correctly. Exclusion criteria: ①a history of neoadjuvant chemotherapy; ②lymph node metastasis indicated by pathology; ③combining with other types of tumors; ④tumor recurrence or metastasis or deaths from any cause within 1 year after surgery; ⑤< 6 months of follow‐up duration from operation (disease‐related factors or early postoperative mental state would affect the assessment of QoL) 19 ; ⑥histories of hypertension, heart disease, diabetes, cerebrovascular accidents, psychiatric illness or/and other long‐term chronic diseases.…”

Application of metagenomic next-generation sequencing in the diagnosis of urinary tract infection in patients undergoing cutaneous ureterostomy

“…Consequently, it is difficult for antibiotics to enter, thus leading to catheter-related UTI, drug resistance, and prolonged UTI (Bader et al, 2013). Recurrent UTI and increasing antimicrobial resistance lead to an increase in readmission rate and economic burden of patients, thus exerting serious effects on a patient's life quality (Flores-Mireles et al, 2015;Liu et al, 2016). Therefore, patients with CU need efficient and precise diagnosis in order to be treated effectively as early as possible and to avoid overtreatment.…”