Decreasing ureteral stent duration following radical cystectomy decreases readmissions and urinary infectious complications.

Authors

null

Hamza Mustafa Beano

Carolinas Medical Center, Charlotte, NC

Hamza Mustafa Beano , Jiaxian He , Caitlin Hensel , William Mills Worrilow , Kris E Gaston , Peter E Clark , Stephen Boyd Riggs

Organizations

Carolinas Medical Center, Charlotte, NC, Levine Cancer Institute, Charlotte, NC, Levine Cancer Institute, Atrium Health, Charlotte, NC, Levine Cancer Institute, Carolinas HealthCare System, Charlotte, NC

Research Funding

Other

Background: Readmission following Radical Cystectomy with Urinary Diversion (RCUD) is often related to Urinary Tract Infection (UTI). We hypothesized that decreasing the duration of ureteral stenting postoperatively would decrease UTI-related complications without affecting ureteroenteric stenosis (UES) rates. Methods: We analyzed a prospectively and retrospectively collected dataset for cystectomy patients at our tertiary center. Adult patient who underwent RCUD for malignancy from January 2013-January 2018 were included. Patients with a history of abdominal/pelvic radiation and continent diversions were excluded. The patient population was divided to Late stent removal group (LSR- POD 14) and early stent removal group (ESR- POD 4). Statistical methods included t-test, chi-square test and multivariate logistic regression. Results: 177 patients were included in the final analysis after inclusion/exclusion criteria were applied. The LSR (n=75) and ESR (n=102) groups were similar in preoperative characteristics except higher intracorporeal ileal conduit formation in ESR. The LSR had higher 90-day overall readmission rates (OR=2.26, 95% CI;1.13,4.51, p-value=0.021), UTI-related readmissions (OR=3.05, 95% CI:1.32,7.04, p-value=0.010) and UAE (OR=3.02, 95%CI;1.47,6.18, p-value=0.003). Conclusions: Shorter ureteral stent duration following RCUD is associated with decreased readmissions and urinary infections complications without concurrent increase in UES. Strong consideration should be directed towards early stent removal.

CharacteristicsAll Patients (n=177)ESR (n=102)LSR (n=75)p-value
LOS- days median(range)6(4-45)6(4-45)6(4-31)0.813
EBL-cc median(range)300(20-3700)300(20-3700)300(20-2400)0.668
Total Readmissions- n(%)52(29.4)24(23.5)28(37.3)0.066
Urinary Readmissions- n(%)32(18.1)12(11.8)20(26.7)0.017
Urinary Adverse Events- n(%)49(27.7)20(19.6)29(38.7)0.007
Ureteral Strictures- n(%)15(8.5)6(5.9)9(12)0.177
Median follow-up- months10.87.815.1<0.001
Median stent duration- days n(range)13(3-43)5(3-29)17(10-43)

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Abstract Details

Meeting

2019 Genitourinary Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session B: Prostate Cancer; Urothelial Carcinoma; Penile, Urethral, Testicular, and Adrenal Cancers

Track

Urothelial Carcinoma,Prostate Cancer,Penile, Urethral, Testicular, and Adrenal Cancers

Sub Track

Urothelial Carcinoma

Citation

J Clin Oncol 37, 2019 (suppl 7S; abstr 366)

DOI

10.1200/JCO.2019.37.7_suppl.366

Abstract #

366

Poster Bd #

F1

Abstract Disclosures

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