Routine stentograms are not necessary before stent removal following radical cystectomy.
Although ureteral stents have significantly reduced perioperative complications of urinary diversion, there is no universal agreement regarding their postoperative management.
As part of an effort to eliminate unnecessary studies and hospital costs for radical cystectomy, we recently reviewed our experience with postoperative radiological stent studies to determine their clinical use and cost.
Materials and Methods
A retrospective examination of medical records and radiographic studies was performed for 96 patients undergoing cystectomy and urinary reconstruction between 1989 and 1996.
All patients were stented at the time of surgery.
Of the patients 51 underwent bilateral retrograde « stentograms » performed under fluoroscopic guidance before stent removal to evaluate for obstruction or urine leak as dictated by the preference of the primary surgeon in each case.
A total of 41 evaluable patients did not undergo stentograms.
In this study 102 stent injections were performed on 51 patients before stent removal.
No patients were found to have ureteral obstruction at the ureterointestinal anastomosis, while 1 (0.98%) had a clinically silent anastomotic leak that healed with conservative measures.
Complications directly attributable to the stent studies, including episodes of urosepsis, were noted in 9 patients (17.6%). Nine additional leaks were diagnosed in this cohort by other means. (...)
Mots-clés Pascal : Carcinome, Vessie urinaire, Traitement, Cystectomie, Association, Anastomose chirurgicale, Uretère, Intestin, Indication, Exploration radiologique, Endoprothèse, Postopératoire, Coût, Résultat, Homme, Tumeur maligne, Appareil urinaire pathologie, Voie urinaire pathologie, Vessie pathologie, Chirurgie, Radiodiagnostic, Economie santé
Mots-clés Pascal anglais : Carcinoma, Urinary bladder, Treatment, Cystectomy, Association, Surgical anastomosis, Ureter, Gut, Indication, Radiologic investigation, Endoprosthesis, Postoperative, Costs, Result, Human, Malignant tumor, Urinary system disease, Urinary tract disease, Bladder disease, Surgery, Radiodiagnosis, Health economy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0449996
Code Inist : 002B25H. Création : 03/02/1998.