Comparison of postradical cystectomy ileus rates using GIA-80 versus GIA-60 intestinal stapler device Journal Article

Authors: Ghanaat, M.; Winer, A. G.; Sjoberg, D. D.; Poon, B. Y.; Kashan, M.; Tin, A. L.; Sfakianos, J. P.; Cha, E. K.; Donahue, T. F.; Dalbagni, G.; Herr, H. W.; Bochner, B. H.; Vickers, A. J.; Donat, S. M.
Article Title: Comparison of postradical cystectomy ileus rates using GIA-80 versus GIA-60 intestinal stapler device
Abstract: Objective: To assess the impact on recovery of bowel function using an 80 mm versus 60 mm gastrointestinal anastomosis (GIA) stapler following radical cystectomy and urinary diversion (RC/UD) for bladder cancer. Methods: We identified 696 patients using a prospectively maintained RC/UD database from January 2006 to November 2010. Two nonrandomized consecutive cohorts were compared. Patients between January 2006- and December 2007 (n = 180) were treated using a 60 mm GIA stapler, and 331 patients between January 2008 and December 2010 were subject to an 80 mm GIA stapler. All patients were treated on the same standardized postoperative recovery pathway. After accounting for baseline patient and perioperative characteristics, using a multivariable logistic regression model, we directly compared rates of postoperative ileus using a standardized definition. Results: Of 511 evaluable patients, ileus was observed in 32% (57/180) for 60 mm GIA versus 33% (110/331) for the 80 mm GIA. Preoperative renal function, age, gender, body mass index, and type of diversion were comparable between cohorts. On multivariate analysis, stapler size was not significantly associated with the development of ileus (GIA-60 vs GIA-80: OR 1.11; 95% CI 0.75, 1.66; P =.6). Positive fluid balance was associated with an increased risk (P =.019) and female sex a decreased risk (P =.008) of developing ileus compared to patients with negative fluid balance. Conclusion: The size of the intestinal bowel anastomosis (GIA 80 mm vs 60 mm) does not independently impact the time to bowel recovery following RC/UD. © 2018 Elsevier Inc.
Journal Title: Urology
Volume: 122
ISSN: 0090-4295
Publisher: Elsevier Science, Inc.  
Date Published: 2018-12-01
Start Page: 121
End Page: 126
Language: English
DOI: 10.1016/j.urology.2018.09.010
PROVIDER: scopus
PUBMED: 30244117
Notes: Urology -- Export Date: 2 January 2019 -- Article -- CODEN: URGYA -- Source: Scopus
Altmetric Score
MSK Authors
  1. Guido Dalbagni
    250 Dalbagni
  2. Sherri M Donat
    135 Donat
  3. Andrew J Vickers
    556 Vickers
  4. Daniel D. Sjoberg
    138 Sjoberg
  5. Bernard Bochner
    323 Bochner
  6. Harry W Herr
    401 Herr
  7. Timothy Francis Donahue
    17 Donahue
  8. Eugene K. Cha
    58 Cha
  9. Jessica Bing Ying Poon
    15 Poon
  10. Amy Lam Ling Tin
    10 Tin
  11. Mahyar   Kashan
    7 Kashan
  12. Mazyar   Ghanaat
    10 Ghanaat