Effects of two types of urinary diversion on complications and prognosis of patients with laparoscopic radical resection of bladder cancer

Objective To explore the effects of two types of urinary diversion on complications and prognosis of patients with laparoscopic radical resection of bladder cancer.

Methods The materials of patients with laparoscopic radical resection of bladder cancer were retrospectively analyzed, and they were divided into ileal conduit surgery group (n=61) and cutaneous ureterostomy group (n=43) according to different types of urinary diversion. The perioperative indicators, incidence of complications, quality of life, and situations of recurrence and death at 2 years after surgery were compared between the two groups.

Results There were no significant differences in general materials such as gender, age, pathological types, number of tumors, clinical staging and lymph mode metastasis between the two groups (P>0.05); the operation time, intraoperative bleeding volume and postoperative recovery time of intestinal function in the ileal conduit surgery group were significantly longer or more than those in the cutaneous ureterostomy group (P < 0.05), but there was no significant difference in postoperative hospital stay between the two groups (P>0.05); there was no significant difference in total incidence rate of complications between two groups(27.87% versus 30.23%, P>0.05), and there were also no significant differences in the incidence rates of various early complications and long-term complications between the two groups (P>0.05). At 6 months after surgery, there was no significant difference in the score of each item of quality of life between the two groups (P>0.05); there were no significant differences in total survival, disease-free survival, 1-year recurrence rate, 2-year total recurrence rate and mortality rate between the two groups (P>0.05).

Conclusion  Compared with ileal conduit surgery, cutaneous ureterostomy has shorter operation time, less intraoperative bleeding volume and less effect on gastrointestinal function, but the complications, quality of life and prognosis are similar between the two operation methods, so it is necessary to choose the appropriate urinary diversion according to the health status of patients and their own wishes in clinical practice.