医学
膀胱切除术
尿路改道
肾切除术
肾功能
围手术期
肾脏疾病
泌尿科
泌尿系统
透析
肾病科
外科
肾
膀胱癌
内科学
癌症
作者
Richard Mateo Mora,Alireza Ghoreifi,Seyedeh‐Sanam Ladi‐Seyedian,Farshad Sheybaee Moghaddam,Jie Cai,Gus Miranda,Monish Aron,Anne Schuckman,Mihir Desai,Inderbir S. Gill,Siamak Daneshmand,Hooman Djaladat
标识
DOI:10.1016/j.urolonc.2022.12.004
摘要
To evaluate perioperative and functional outcomes of radical cystectomy (RC) and urinary diversion (UD) in patients with a single kidney (SK) vs. double kidneys (DK).We reviewed records of patients who underwent RC for bladder cancer with a history of prior or concurrent nephrectomy at USC between 2004 and 2020. Patients with chronic kidney disease who were already on dialysis were excluded. UD, perioperative complications, and postoperative glomerular filtration rate (GFR) of the SK group were compared with a group of patients who underwent RC with DK using 2:1 matching with respect to age, sex, preop GFR, and tumor stage.We included 186 patients (SK = 62 and DK = 124). Half of the SK patients underwent continent UD. SK patients had a higher length of hospital stay compared to the DK group; however, 90-day complications, readmission, and mortality rates were similar. In patients with continent diversion, SK vs. DK showed similar 90-day complications (71% vs. 69%, P = 1.0). SK patients had significantly lower GFRs at discharge, 3-, and 12-month following RC compared to the DK group. Postoperative GFRs of the SK patients with continent vs. incontinent UD were statistically similar. On multivariable analysis, UD (i.e. continent vs. incontinent) was not associated with post-op GFR decline at discharge, 3- and 12-month following RC.Perioperative outcomes of radical cystectomy patients with single kidney are similar to double kidney patients, except for more GFR decline in single kidney cases. Continent urinary diversion in single kidney is as safe as double kidney patients.
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