Nahar B, et al. - The upshot of urinary diversion type following radical cystectomy (RC) on readmission and short-term mortality rates were assessed in patients with bladder cancer. Marginally increased rates of readmission were reported among patients undergoing orthotopic neobladder (NB) compared to ileal conduit (IC). Surgery performed at a non-academic center exhibited a correlation with higher readmission and 30-day mortality. The different types of urinary diversion displayed similar short-term mortality rates.

Methods

• The study cohort comprised of patients who underwent RC for bladder cancer in the National Cancer Data Base.
• They were grouped on the basis of the type of urinary diversion performed: Non-continent [ileal conduit (IC)] or two continent techniques [continent pouch (CP) and orthotopic neobladder (NB)].
• For comparing the 30-day readmission and 30- and 90-day mortality between the different types of urinary diversion, the propensity score matching and multivariable logistic regression models were used.

Results

• Among 11,933 patients who underwent RC, 10,197 (85.5%) IC, 1044 (8.7%) CP, and 692 (5.8%) NB were detected.
• Those who received IC were found to be considerably older with more comorbidities (p < 0.0001).
• Continent diversions exhibited a greater likelihood of being performed at an academic center (p < 0.0001).
• Surgery performed at a non-academic center was discovered to be an independent predictor of 30-day readmission (OR 1.19, p=0.010) and 30-day mortality (OR 1.27, p=0.043).
• An increased tendency of readmission was noted among patients undergoing NB (OR 1.41, p = 0.010).
• No notable variation was disclosed in the short-term mortality between groups.