Individualized Selection Of Three Types Of Urinary Diversion After Radical Resection Of Bladder Cancer

Objective:Three kinds of urinary diversion procedures were compared between cotaneous ureterostomy,ileal conduit and orthotopic bladder substitute.The differences in perioperative data and postoperative results of three urinary diversions were investigated.Screening out patients aged ?60 years for comparison,providing a reference for the choice of different urinary diversion after urinary diversion.Methods:A total of 117 patients who underwent radical cystectomy and urinary diversion in our center from January 2014 to June 2017 were collected.according to different urinary diversion methods,the patients were divided into CU group,IC group and OBS group.the three groups of urinary diversion were compared systematically and compared between groups,including perioperative data,surgical complications and oncology results.the patients with ? 60 years old were screened and the performance of three urinary diversion procedures in older patients was compared.Results:A total of 117 patients were enrolled,including 96 males and 21 females.according to different urinary diversion procedures,it is divided into three groups: CU group,IC group and OBS.all patients underwent successful operation in our center without serious postoperative complications and no perioperative deaths.the average operation time of the three groups of urinary diversion was 338.1±64.0 min,a comparative analysis of uncontrollable urinary diversion with no significant difference in age was carried out.the CU group was shorter than the IC group(p=0.036).while the intraoperative bleeding was lower in the CU group than in the IC group(p=0.042,).the CU group had an advantage in postoperative gastrointestinal function recovery and postoperative extubation time.The CU group was compared with the IC group(p=0.035,p=0.004).the postoperative hospital stay was the shortest in the CU group(p=0.005).the number of complications in the CU group was lower than that in the IC group(p=0.022).a total of 66 patients aged ?60 years were included in the analysis,including 46 in the CU group and 10 in the IC and OBS groups.the average operative time in the CU group was 315.1 ± 49.5 min,which was shorter than the IC group and the OBS group(p=0.010,p=0.002).There was no significant difference in the operation time between the IC group and the OBS group(p=0.689).there was no significant difference in the amount of intraoperative blood loss and perioperative blood transfusion between the three groups(p=0.292,p=0.352).gastrointestinal function recovery and extubation time were lower in the CU group than in the OBS group(p=0.001,p<0.001),but not significantly different from the IC group(p=0.103,p=0.036).in terms of postoperative hospital stay,the CU group was less than the IC group and the OBS group(p=0.001,p=0.010),but there was no significant difference in the postoperative hospital stay between the IC group and the OBS group(p=0.532).there were no significant differences in the number of postoperative complications between the three groups(p>0.01).transitional cell carcinoma is the most common in postoperative pathology.Conclusion:In the incontinent diversion,CU group has better performance than IC.As the population ages,there are more and more elderly patients with bladder cancer.This study screened patients aged ?60 years and compared them.the results showed that achieved satisfactory results in elderly patients.