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Is the incidence of uretero‐intestinal anastomotic stricture increased in patients undergoing radical cystectomy with previous pelvic radiation?
Author(s) -
Katkoori Devendar,
Samavedi Srinivas,
Adiyat Kishore Thekke,
Soloway Mark S.,
Manoharan Murugesan
Publication year - 2010
Publication title -
bju international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.773
H-Index - 148
eISSN - 1464-410X
pISSN - 1464-4096
DOI - 10.1111/j.1464-410x.2009.08835.x
Subject(s) - medicine , cystectomy , anastomosis , urinary diversion , surgery , incidence (geometry) , radiation therapy , urethral stricture , pathological , bladder cancer , urology , cancer , urethra , physics , optics
Study Type – Therapy (case series)
Level of Evidence 4 OBJECTIVE To present our long‐term experience comparing uretero‐intestinal anastomotic (UIA) stricture rates after radical cystectomy (RC) in patients with and without previous pelvic radiotherapy (pRT), as the risk of stricture is thought to be higher in patients undergoing RC and urinary diversion (UD) with a history of pRT. PATIENTS AND METHODS We retrospectively analysed patients who had RC and UD between 1992 and 2008 by one surgical team. Patients were divided into two groups, those with (group 1) and with no (group 2) previous pRT. Relevant clinical and pathological data were entered into a database. Patients who were symptomatic and required intervention for a UIA stricture were analysed; patients with malignant strictures were excluded. RESULTS In all, 526 patients had RC by one surgical team during the study period; 65 had pRT before RC, 37 for prostate cancer, 23 for bladder cancer and the rest for other pelvic malignancies. All the patients in group 1 had an ileal conduit (IC) diversion. There were 250 IC and 211 neobladder diversions in group 2. There were 130 (12%) UIAs in group 1, vs 922 (88%) in group 2. There was no statistically significant difference between the groups in demographic profile and follow‐up. The overall stricture rate for UIA was 1.3%; there were two (1.5%) UIA strictures in group 1 vs 12 (1.3%) in group 2. The mean (median, range) time to onset of the stricture was 10 (6, 2–39) months. There was no statistically significant difference in stricture rate between the groups ( P > 0.05). CONCLUSIONS In patients undergoing RC with UD there was no significant difference in UIA stricture rates between those with and without previous pRT.