4.6 Article

Comparison of open and intracorporeal modified ureterosigmoidostomy (Mainz II) after laparoscopic radical cystectomy with bladder cancer

Journal

WORLD JOURNAL OF SURGICAL ONCOLOGY
Volume 19, Issue 1, Pages -

Publisher

BMC
DOI: 10.1186/s12957-021-02148-y

Keywords

Ureterosigmoidostomy; Urinary diversion; Mainz pouch II; Laparoscopy; Radical cystectomy; Urothelial carcinoma of the bladder

Funding

  1. key research and development (R&D) projects of Gansu Province [17YF1FA126]
  2. Lanzhou University Second Hospital [YJS-BD-25]
  3. CuiYing Science and Technology Innovation plan project of Lanzhou University Second Hospital [CY2017-BJ05]

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The study compared perioperative and oncologic outcomes of OMUUD and IMUUD after LRC, finding that IMUUD has faster postoperative recovery with similar perioperative and oncologic results compared to OMUUD.
Objective To compare perioperative and oncologic outcomes of open modified ureterosigmoidostomy urinary diversion (OMUUD) and intracorporeal modified ureterosigmoidostomy urinary diversion (IMUUD) following laparoscopic radical cystectomy (LRC). Patients and methods We retrospectively reviewed our single institutional collected database patients undergoing LRC from October 2011 to October 2019. The perioperative characteristics were compared between OMUUD and IMUUD, and overall survival (OS) and progression-free survival (PFS) were evaluated by the Kaplan-Meier method. Results Overall, 84 patients were included. OMUUD and IMUUD were performed in 63 (75%) and 21 (25%) patients, respectively. IMUUD patients demonstrated shorter postoperative length of stay (16.24 +/- 3.91 days vs. 18.98 +/- 7.41 days, P = 0.033), similar operation time (498.57 +/- 121.44 vs. 462.24 +/- 99.71, P = 0.175), similar estimated blood loss [400 (200-475) ml vs. 400 (200-700) ml, P = 0.095], and similar overall complication rate within 30 days (19.05% vs. 25.40%, P = 0.848) and 90 days (23.81% vs. 17.46%, P = 0.748). Complete urinary control rate was 87.3% (55/63) in the OMUUD group. In IMUUD, the complete urinary control rate was 90.5% (19/21). There was no significant difference in OS (chi(2) = 0.015, P = 0.901) and PFS (chi(2) = 0.107, P = 0.743) between the two groups. Conclusion IMUUD postoperative recovery is faster; other perioperative outcomes and oncology results are not significantly different with OMUUD. It is indicated that IMUUD can be utilized safely and effectively in the urinary diversion after LRC.

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