| 篇名 |
The absence of urinary diversion in radical cystectomy avoids early complications in hemodialysis patients |
| 作者 |
Yun‑Ta Yang, Jui‑Ming Liu, Cheng‑Feng Lin, Kuan‑Lin Liu, Cheng‑Chia Lin, Chun‑Te Wu |
| 卷期/出版年月 |
55卷2期 (2022/4) |
| 頁次 |
44-51 |
| 摘要 |
Background: Patients with end‑stage renal disease who receive dialysis are considered a high‑risk group for perioperative complications following anesthesia and surgery. However, for patients with anuria who will undergo radical cystectomy (RC), a urinary diversion is unnecessary. This study aimed to identify a safe surgical strategy by comparing oncologic outcomes and early complication rates in dialysis and nondialysis patients after RC.
Materials and Methods: This study included 85 patients with primary urothelial cell carcinoma of the bladder who underwent RC at the Chang Gung Memorial Hospital, Keelung, Taiwan. Twenty‑eight of these patients underwent regular hemodialysis. Overall survival and recurrence‑free survival were compared
to evaluate the oncologic outcomes. Complications at 3 months were graded using the Clavien–Dindo classification.
Results: The overall survival and recurrence‑free survival differences between dialysis and nondialysis patients were not significant (P = 0.686; P = 0.528). The degree of muscle‑invasive disease was an independent factor affecting overall survival. The overall complication rates in the dialysis and nondialysis groups were 36% and 84%, respectively (P < 0.001). The major complication (Grades III–V) was 16% in the dialysis group and 28% in the nondialysis group (P = 0.241). The most common early complications were urinary tract infection and bowel kinetics change, and both were significantly lower in the dialysis group. A lower re‑admission rate was also observed in the dialysis group.
Conclusion: Lower rates of early complications and acceptable survival outcomes were observed in dialysis patients. Surgery can be conducted more aggressively, with confidence in suitable cases. |
| 關鍵詞 |
Bladder urothelial carcinoma, end‑stage renal disease, hemodialysis, radical cystectomy, urinary diversion |
| 分類 |
Original |
