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

Abstract

Objectives

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

Materials and Methods

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.

Results

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).

Conclusions

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.