Ureteroileal anastomosis-associated complications of radical cystectomy with ileal conduit in bladder cancer treatment

Background. Radical cystectomy remains the gold standard of bladder cancer treatment for both muscle invasive form and high-risk patients. However, despite the patients' high quality of life after radical cystectomy, formation of ureteroileal anastomoses (UIA) is still associated with a number of serious complications at various times in the postoperative period. Aim. To evaluate the effectiveness of an original technique of UIA formation in the context of development of postoperative complications. Materials and methods. At the N.N. Petrov National Medical Research Center of Oncology between January 2012 and October 2023, 465 radical cystectomies with ileal conduit were performed. In retrospective analysis, patients were divided into two groups: group 1 (n = 285) with the conventional technique for forming UIA, group 2 (n = 180) with a modified technique. Clinical and demographic characteristics of the groups were compared using t-test and chi 2-test. Multivariate logistic regression analysis was performed to determine the likelihood of complications associated with UIA. Results. Both groups were matched by clinical and demographic characteristics. The overall rate of complications associated with UIA was slightly lower in group 2 than in the conventional technique group (15 % vs. 16 %; p <0.001). Late complications associated with UIA were observed significantly less in the modification group (2.7 % vs. 4.2 %; p <0.001), and in group 2 repeat surgical interventions were required significantly less often. In multivariate analysis, the modified technique group was significantly less likely to develop UIA-associated complications than the conventional technique group (odds ratio 0.123; 95 % confidence interval 0.06-0.22 vs. odds ratio 0.179; 95 % confidence interval 0.12-0.27; p <0.001). Conclusion. The presented modified technique of UIA formation can be quite effective in reducing the risk of developing UIA-associated complications.