Differences in Morbidity of Neobladder versus Ileal Conduit: A Matched Pair Analysis on 134 Patients

Abstract

Objective The objective of this study is to evaluate whether performing an ileal conduit (IC) versus a neobladder (NB) during radical cystectomy (RC) can play a role on the morbidity of the surgical procedure. Materials and Methods At our institution since 2001, a database collecting the data of more than 450 patients who have undergone RC is perspectively maintained. The records of 246 patients submitted to RC and IC and 120 to RC and NB have been reviewed for the present study. By a binary logistic regression model, a propensity score was generated joining these factors: gender, age, smoking habit, Charlson' comorbidity score, platelet antiaggregants or oral anticoagulant therapy, ASA (American Society of Anesthesiologists) score, hydronephrosis, pathologic T stage, and lymphadenectomy. A group of patients submitted to IC and another to NB having the closer propensity score were created with a matching ratio of 1:1. The following features were compared between the two groups: operative time, blood loss, intraoperative complication rate, and postoperative complications rate (overall, clavien 1–2, clavien ≥3, related to RC, relate to urinary reconstruction). Results One hundred thirty-four patients were selected, 67 submitted to NB, 67 to IC, well matched according to the desired features. No differences were noted for all the compared features. Conclusion The morbidity of RC does not seem to be dependent on the choice to perform IC versus NB.