Continent cutaneous diversion: Unveiling the interplay of neuro-urology and oncological challenges.

Autor:	El Khoury MA; Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France; Université libre de Bruxelles, Faculté de Médecine, Bruxelles, Belgium. Electronic address: michael-elkhoury@hotmail.com., Chartier-Kastler E; Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France; Sorbonne Université, Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France., Parra J; Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France., Vaessen C; Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France., Roupret M; Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France; Sorbonne Université, Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France., Seisen T; Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France; Sorbonne Université, Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France., Lenfant L; Hôpital Universitaire Pitié-Salpétrière, AP-HP, Paris, France.
Jazyk:	angličtina
Zdroj:	The French journal of urology [Fr J Urol] 2024 Jun; Vol. 34 (6), pp. 102665. Date of Electronic Publication: 2024 Jun 05.
DOI:	10.1016/j.fjurol.2024.102665
Abstrakt:	Objectives: The objective of our study is to demonstrate the practical application of continent cutaneous urinary diversion (CCUD) in oncological patients, with a focus on various aspects of the procedure: surgical challenges, functional outcomes, and quality of life. Materials and Methods: We studied the perioperative and follow-up data of patients who underwent cystectomy for cancer associated with CCUD (Mitrofanoff, Monti or Casale). We retrospectively analyzed complications within 30days and beyond 30days post-surgery. We evaluated oncological outcomes. Patients' quality of life was assessed using the Bladder Cancer Index (BCI) questionnaire. Results are given on an intention-to-treat basis. Results: A total of 24 patients were included in the study (July 2001 and May 2022), with a median follow-up of 62.5months. We report three deaths due to neoplasic recurrence. Forty-six percent had an early postoperative complication, two of whom required revision surgery. Overall, the medium-term complication rate was 70% and the reoperation rate was 62%. There were 8 stomal cutaneous stenoses (33%) and 3 uretero-ileal stenoses (12.5%). Overall satisfaction was rated at 9.2/10 on average, and body image was unaltered or slightly altered in 62.5% of patients. Of the patients who responded to the BCI, 75% had complete continence. Discussion: The experience gained with continent stomas in neuro-urology has allowed, in carefully selected cases, to offer patients an alternative that can improve their quality of life in a context already burdened by the shadow of cancer. CCUD can be proposed as an alternative to Bricker diversion in cases of urethral invasion or a high risk of neobladder incontinence, in selected patients. (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)
Databáze:	MEDLINE
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