TRANSPERITONEAL URETERCUTANEOSTOMY WITH USE OF MESOSIGMOID COLON PERITONEUM IN PATIENTS WITH BLADDER CANCER AFTER RADICAL CYSTECTOMY

Abstract

The aim of the study was to we describe the new surgical approach of constructing single site transperitoneal cutaneostomy with the use of sigmoid colon accompanied by skin modified fixation technique and its clinical outcomes. Materials and methods: 89 patients were included in a single center study from January 2015 to May 2019. All patients underwent single-site modified transperitonial ureterocutanesotomy. Clinical and surgical data were analyzed. Statistical analyses were performed using SPSS 22.0. Results: Majority of the patients had a low performance status and rationale for cystectomy was palliative cytoreduction. Almost half of the patients had upper tract obstruction at diagnosis with 40% of patients presenting with a decreased kidney function. Surgical procedure was safe taking to account locally advanced. All the surgeries were performed with acceptable complications rate. Blood loss didn’t exceeded 1000 ml and median operation time was 194 minutes. Early and late postoperative complications were analyzed and stomal stenosis that needed continuous restenting or reoperation was seen in 20% of cases. Conclusions: Single-site modified transperitonial ureterocutanesotomy is safe and effective surgical approach with acceptable complication rates and duration. Such surgery may be used as a major urinary diversion approach in advanced bladder cancer patients with severe symptoms and low-performance status. Further external validation studies needed to evaluate efficacy of the proposed technique.