Can Extraperitonealization of Ileal Conduit Protect from Postoperative Bowel Complications in Patients Who Have Undergone Radical Cystectomy with the Diagnosis of Bladder Cancer?

Abstract

Objective: Radical cystoprostatectomy is the most important treatment option in local control and standard surgical treatment in muscle-invasive bladder cancer, and also has serious complications that occur during the postoperative period. We have aimed to evaluate postoperative bowel complications with peritoneal closure-assisted ileal conduit extraperitonealization technique. Materials and Methods: The data of 98 patients who underwent radical cystectomy and ileal conduit urinary diversion with the diagnosis of non-metastatic bladder cancer between 2015 and 2023 were retrospectively screened. The groups of patients who underwent extraperitonealization of the ileal conduit with radical cystectomy and traditional radical cystectomy were evaluated comparatively in terms of perioperative outcomes and postoperative complications. Results: Forty-five patients who underwent cystectomy with ileal conduit extraperitonealization technique and 53 patients who underwent ileal loop diversion with traditional cystectomy were evaluated comparatively. There was no statistically significant difference between the two groups in terms of demographic characteristics and duration of surgery. In the group that underwent cystectomy with extraperitonealization of the ileal conduit technique, the return of the normal gas pattern and the dwell time of the nasocracymic tube were statistically significantly shorter than the group that did not (p=0.017, p=0.023). The average length of hospital stay was 7.2 days in the extra-peritonealization group and 14.1 days in the group that did not undergo extraperitonealization, and this period was significantly shorter in the extraperitonealized group (p=0.013). There were no complications requiring reoperation in the extraperitonealized group. Conclusion: In radical cystectomy and ileal loop cutaneous urinary diversion, extraperitonizing the ileal segment reduces postoperative intestinal complications.