Extraperitonealization of the ileal conduit decreases the risk of parastomal hernia: A single-center, randomized clinical trial
Zhaohui Zhou, Longbin Xiong, Kai Yao, Huali Ma, Wensu Wei, Zhiling Zhang, Shengjie Guo, Pei Dong, Xiangdong Li, Lijuan Jiang, Dong Chen, Zike Qin, Hui Han, Yunlin Ye, Yonghong Li, Yanjun Wang, Zhiming Wu, Li Tian, Chunping Yu, Fangjian Zhou, Zhiyong Li, Zhuowei Liu
Abstract
Parastomal hernia (PSH) is a common complication in patients receiving ileal conduit urinary diversion after radical cystectomy. In this randomized controlled clinical trial, we validate our previous finding that extraperitonealization of ileal conduit decreases incidence of PSH. In total, 104 consecutive patients undergoing radical cystectomy at Sun Yat-sen University Cancer Center are randomized 1:1 to receive either modified (extraperitonealized) ileal conduit (n = 52) or conventional ileal conduit (n = 52). Primary endpoint is incidence of radiological PSH during follow-up. Incidence of radiological PSH is lower in the modified group than in the conventional group (11.5% vs. 28.8%; p = 0.028) after a median follow-up of 32 months, corresponding to a hazard ratio of 0.374 (95% confidence interval: 0.145-0.965, p = 0.034) in the modified conduit group. The results support our previous finding that extraperitonealization of the ileal conduit is effective for reducing risk of PSH in patients receiving ileal conduit diversion.