Mp22-18 Body Morphometry Analysis Can Identify Patients at Risk of Parastomal Hernia Following Radical Cystectomy With Ileal Conduit

You have accessJournal of UrologyBladder Cancer: Invasive II (MP22)1 May 2024MP22-18 BODY MORPHOMETRY ANALYSIS CAN IDENTIFY PATIENTS AT RISK OF PARASTOMAL HERNIA FOLLOWING RADICAL CYSTECTOMY WITH ILEAL CONDUIT Zaeem Lone, David Shin, Rebecca A. Campbell, Eiftu Haile, Andrew Wood, Mohamed Eltemamy, Samuel C. Haywood, Georges-Pascal Haber, Christopher J. Weight, Jihad Kaouk, Steven C. Campbell, Ryan Ellis, Lucas Beffa, Ajita Prabhu, Clayton Petro, Michael J. Rosen, Benjamin T. Miller, Erick M. Remer, and Nima Almassi Zaeem LoneZaeem Lone , David ShinDavid Shin , Rebecca A. CampbellRebecca A. Campbell , Eiftu HaileEiftu Haile , Andrew WoodAndrew Wood , Mohamed EltemamyMohamed Eltemamy , Samuel C. HaywoodSamuel C. Haywood , Georges-Pascal HaberGeorges-Pascal Haber , Christopher J. WeightChristopher J. Weight , Jihad KaoukJihad Kaouk , Steven C. CampbellSteven C. Campbell , Ryan EllisRyan Ellis , Lucas BeffaLucas Beffa , Ajita PrabhuAjita Prabhu , Clayton PetroClayton Petro , Michael J. RosenMichael J. Rosen , Benjamin T. MillerBenjamin T. Miller , Erick M. RemerErick M. Remer , and Nima AlmassiNima Almassi View All Author Informationhttps://doi.org/10.1097/01.JU.0001008608.50694.4b.18AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Development of parastomal hernia (PH) is prevalent after radical cystectomy (RC). There are limited data on whether body morphometry is predictive of this complication. We sought to evaluate the association of skeletal muscle and fat mass index on risk of PH after RC. METHODS: A retrospective review of patients who underwent RC with ileal conduit urinary diversion between 2010-2020 was performed. Inclusion criteria were CT A/P before surgery and at one and two-year post-operative visits. Utilizing Intuition by TeraRecon software, pre-operative axial images at L3 were identified and the cross-sectional skeletal mass and adipose were measured. Skeletal mass indices (SMI) were calculated by normalizing the total skeletal muscle area by height (cm2/m2) and patients were classified as sarcopenic according to gender specific reference values (male: SMI9 kg/m2 and females: FMI>13 kg/m2). PH were graded according to the Moreno-Matias (M-M) and European Hernia Society (EHS) classification. Kaplan Meier (KM) curves with log rank test were utilized to predict PH free survival and Cox Proportional Hazards regression models identified predictors of PH development. RESULTS: 367 patients were included with 159 developing CT evidence of PH (43%). Patients with PH had a higher BMI (36 vs. 30, p<0.001), more visceral fat (306 vs. 208 cm2, p<0.001), a higher preoperative FMI (11 vs. 9.3 kg/m2, p<0.001), and higher rates of sarcopenia/obesity (44% vs. 12%, p<0.001). On KM analysis, patients who were obese or sarcopenic/obese were more likely to develop a PH (p<0.001). On Cox Proportional Hazard regression, obesity as per fat mass index (Hazard Ratio (HR) 2.51, p=0.032), visceral fat (HR: 1.002, p=0.017) and subcutaneous fat (HR: 1.003, p=0.020) were the only significant predictors of PH formation. Notably, surgical approach (open, robotic cystectomy with extracorporeal diversion, or intracorporeal cystectomy and diversion) were not significant predictors of PH. CONCLUSIONS: Fat mass index as determined by preoperative body morphometry analysis was the strongest predictor for the development of PH following RC. Download PPT Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e351 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Zaeem Lone More articles by this author David Shin More articles by this author Rebecca A. Campbell More articles by this author Eiftu Haile More articles by this author Andrew Wood More articles by this author Mohamed Eltemamy More articles by this author Samuel C. Haywood More articles by this author Georges-Pascal Haber More articles by this author Christopher J. Weight More articles by this author Jihad Kaouk More articles by this author Steven C. Campbell More articles by this author Ryan Ellis More articles by this author Lucas Beffa More articles by this author Ajita Prabhu More articles by this author Clayton Petro More articles by this author Michael J. Rosen More articles by this author Benjamin T. Miller More articles by this author Erick M. Remer More articles by this author Nima Almassi More articles by this author Expand All Advertisement PDF downloadLoading ...