Perioperative outcomes and complications analysis of ileal conduit and cutaneous ureterostomy in elderly patients undergoing robot-assisted radical cystectomy:a single-center study
Objective:To demonstrate the short-term efficacy of ileal conduit(IC)compared with cutaneous ureterostomy(CU)in patients aged 65 years or older undergoing robot-assisted radical cystectomy(RARC).Meth-ods:Clinical data of 83 patients aged 65 years or older who underwent RARC at the Department of Urology,First Affiliated Hospital of Chongqing Medical University from June 2016 to February 2024 were retrospectively ana-lyzed.Among these patients,46 underwent IC and 37 underwent CU.After adjusting patient characteristics using propensity score matching(PSM)based on baseline data of enrolled patients,perioperative outcomes and postoper-ative 30-day prognosis were compared between the two groups of patients before and after PSM.Results:Prior to PSM,the CU group exhibited older age(P＜0.01),higher age-adjusted Charlson comorbidity index(aCCI)values(P＜0.01),and shorter operation time(P=0.002)compared to the IC group.Post PSM,no statistically signifi-cant differences were observed in age or aCCI values between two groups.Before and after PSM,compared with the IC group,patients in the CU group had a shorter postoperative hospital stay(P=0.002,P=0.022),less in-traoperative blood loss(P＜0.001,P=0.005),lower rates of postoperative complications at 30 days(P=0.008,P=0.016),and lower probabilities of developing urinary leakage(P=0.013,P=0.028)and intestinal obstruc-tion(P=0.037,P=0.028).Conclusion:For elderly patients with muscle-invasive bladder cancer who have mul-tiple systemic diseases and poor general conditions,RARC+CU surgery may demonstrate better short-term efficacy.
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