Pd21-04 a Comparative Analysis of Complication Rates in Urinary Diversions: Exploring the Impact of Contemporary Surgical Trends

You have accessJournal of UrologyReconstruction: Augmentation, Substitution, Diversion (PD21)1 May 2024PD21-04 A COMPARATIVE ANALYSIS OF COMPLICATION RATES IN URINARY DIVERSIONS: EXPLORING THE IMPACT OF CONTEMPORARY SURGICAL TRENDS John Pfail, Alain Kaldany, Rachel Passarelli, Kevin Chua, Benjamin Lichtbroun, Arnav Srivastava, David Golombos, Thomas L. Jang, Vignesh T. Packiam, and Saum Ghodoussipour John PfailJohn Pfail , Alain KaldanyAlain Kaldany , Rachel PassarelliRachel Passarelli , Kevin ChuaKevin Chua , Benjamin LichtbrounBenjamin Lichtbroun , Arnav SrivastavaArnav Srivastava , David GolombosDavid Golombos , Thomas L. JangThomas L. Jang , Vignesh T. PackiamVignesh T. Packiam , and Saum GhodoussipourSaum Ghodoussipour View All Author Informationhttps://doi.org/10.1097/01.JU.0001008888.07102.14.04AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Historically, outcomes have been similar among patients undergoing continent and incontinent diversion at time of radical cystectomy, with no difference in complication rates. Given the decreasing rates of continent diversion, we sought to examine postoperative complication rates based on type of diversion in a contemporary cohort. METHODS: Data was extracted from the National Surgical Quality Improvement Program (NSQIP) database including all patients from 2019-2021 who underwent radical cystectomy. Patients were stratified based on diversion type. Baseline sociodemographic and patient characteristics were included in univariable analysis. Primary endpoints included 30-day complications, length of stay (LOS), and readmissions. Multivariable analyses assessing for confounders was performed to determine the association of urinary diversion type with post-operative morbidity. RESULTS: A total of 4375 patients were identified, including 3780 who underwent incontinent diversion and 595 who underwent continent diversion. Compared to patients with continent diversion, those with incontinent diversion were more likely to be older, female, have higher ASA, worse renal function, have robotic/laparoscopic approach, history of radiation or pelvic surgery, and higher stage (Table 1). On multivariable analysis, patients with continent diversion had increased odds of any complication (OR 1.25, 95%CI 1.03-1.52), ureteral obstruction (1.89, 95%CI 1.18-3.03), anastomotic leak (OR 2.52, 95%CI 1.53-4.13), and readmission (OR 1.71, 95%CI 1.37-2.12), compared to incontinent diversion. CONCLUSIONS: In a contemporary cohort of patients undergoing radical cystectomy, odds of adverse postoperative outcomes were increased among those undergoing continent diversion compared to incontinent diversion, despite more favorable baseline characteristics in this cohort. Source of Funding: N/A © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e454 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information John Pfail More articles by this author Alain Kaldany More articles by this author Rachel Passarelli More articles by this author Kevin Chua More articles by this author Benjamin Lichtbroun More articles by this author Arnav Srivastava More articles by this author David Golombos More articles by this author Thomas L. Jang More articles by this author Vignesh T. Packiam More articles by this author Saum Ghodoussipour More articles by this author Expand All Advertisement PDF downloadLoading ...