Temporal Trends in Urinary Diversion among Patients Undergoing Radical Cystectomy Between 1986 and 2022: Experience at the University Medical Center Mainz with 2224 Cases.

Autor: Duwe G; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany. gregor.duwe@unimedizin-mainz.de., Kamal MM; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany., Wiesmann C; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany., Banasiewicz KE; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany., Wagner I; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany., Fischer ND; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany., Haack M; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany., Frey LJ; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany., Mager R; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany., Höfner T; Department of Urology, Ordensklinikum Linz Elisabethinen, Linz, Austria., Sparwasser P; Department of Urology, University Hospital and Faculty of Medicine Eberhard Karls University Tübingen, Tuebingen, Germany., Tsaur I; Department of Urology, University Hospital and Faculty of Medicine Eberhard Karls University Tübingen, Tuebingen, Germany., Wiesner C; Department of Urology, Klinikum Osnabrück GmbH, Osnabrück, Germany., Thomas C; Department of Urology, University Hospital Carl Gustav-Carus, TU Dresden, Dresden, Germany., Thüroff JW; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany., Hohenfellner R; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany., Brandt MP; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany., Haferkamp A; Department of Urology and Paediatric Urology, University Medical Center of the Johannes Gutenberg-University Mainz, Mainz, Germany.
Jazyk: angličtina
Zdroj: Annals of surgical oncology [Ann Surg Oncol] 2024 Oct; Vol. 31 (10), pp. 7220-7228. Date of Electronic Publication: 2024 Jul 05.
DOI: 10.1245/s10434-024-15730-x
Abstrakt: Background: Analysis of temporal trends of urinary diversion (UD) and identification of predictive factors for continent urinary diversion (CUD) in patients with bladder cancer (BC) is scarce and data on large cohorts are missing. We aimed to describe longitudinal temporal trends and predictive factors for UD among patients with BC receiving radical cystectomy (RC).
Patients and Methods: We retrospectively analysed institutional data collected from patients undergoing RC from 1986 to 2022 to describe changes in patients' characteristics and UD. Primary end points were patients' characteristics associated with type of UD. Logistic regression analysis was used to determine predictive factors for CUD.
Results: In total, 2224 patients (77.16% male, 22.84% female) with a mean age of 66 years [standard deviation (SD), 10.64 years] were included. We observed an increase in mean age from 59.86 (10.8) years (1986-1990) to 69.85 (9.99) years (2016-2022) (p < 0.001). The proportion of CUD gradually declined from 43.72% (94/215; 1986-1990) to 18.38% (86/468; 2016-2022). Patients who were male [odds ratio (OR): 1.92, 95% confidence interval (CI): 1.43-2.57, p < 0.001), younger (OR: 0.88, 95% CI: 0.87-0.89, p < 0.001) and had no hydronephrosis prior to RC (OR: 2.2, 95% CI: 1.66-2.92, p < 0.001) were more likely to receive CUD.
Conclusions: We report the largest European single-center cohort of UD after RC, demonstrating a significant shift from CUD to IUD, accompanied by an increasing age. Finally, our data mirrors the development and extensive experience with the Mainz Pouch-I in the 1980's and 1990's together with other colon pouches.
(© 2024. The Author(s).)
Databáze: MEDLINE
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