A prospective analysis of ureteral stenting during radical cystectomy and ileal conduit urinary diversion: Paediatric feeding tubes versus single‐J stents

TL;DR

This study compares the use of pediatric feeding tubes and single-J stents during bladder cancer surgery and finds similar outcomes, with feeding tubes linked to fewer infections and shorter hospital stays.

Contribution

The study provides a prospective comparison of two ureteral stenting methods during radical cystectomy with ileal conduit urinary diversion.

Findings

Feeding tubes were associated with a lower UTI rate compared to single-J stents (4% vs. 23%).

Hospital stay was shorter for patients with feeding tubes (6 vs. 8 days).

No significant differences were found in stricture, urine leak, or ileus rates between the two groups.

Abstract

This study compares postoperative outcomes of radical cystectomy (RC) with ileal conduit urinary diversion (ICUD) using paediatric feeding tubes versus single‐J ureteral stents.

Patients underwent RC with ICUD for bladder cancer between 2011 and 2018. Prospective preoperative clinical, operative and postoperative data were collected. Postoperative complications including stricture, urine leak, urinary tract infection (UTI) and ileus were compared between patients who received 5‐Fr paediatric feeding tubes or 7‐Fr single‐J ureteral stents during surgery.

Two hundred thirty‐four patients underwent RC with ICUD including 26 with paediatric feeding tubes and 208 with single‐J ureteral stents; 41% had robotic cystectomy, with 36% of these undergoing intracorporeal ICUD. Both groups were comparable in age, gender, kidney function and comorbidities. No significant differences were observed between groups for rates of ileus (20% vs. 34%, p = 0.14), urine leak (4% vs. 10%, p = 0.3), uretero‐ileal stricture (16% vs. 18%, p = 0.7) or overall urinary complications (20% vs. 37%, p = 0.12), except for a lower UTI rate in the feeding tube group (4% vs. 23%, p = 0.02). Median hospital stay was shorter in the feeding tube group (6 vs. 8 days, p = 0.015) with similar readmission rates compared to the stent group (p = 0.96).

Using 5‐Fr feeding tubes for ureteral stenting during RC with ICUD is a safe alternative to 7‐Fr single‐J stents, especially for patients with small ureters or delicate anatomy. Stent type showed no significant impact on postoperative urinary complications except for a lower UTI rate with feeding tubes, suggesting comparable overall outcomes between the two stent types.

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