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근치적 방광 절제 및 요루전환을 시행한 환자에서 열성 요로감염에 대한 특성 |
| 양산부산대학교병원 비뇨의학과 |
| 이단비, 백승룡, 송원훈, 이승수, 박성우, 남종길 |
Introduction: To compare the incidence of febrile urinary tract infection (UTI) and bacterial identification between patients with orthotopic neobladder (ONB) and ileal conduit (IC).
Materials and Methods: Data of 164 patients who underwent radical cystectomy with ONB and IC for bladder cancer between January 2009 and January 2018 at our institution were analyzed. Febrile UTI observed was listed and subsequently compared. Incidence of febrile UTI, clinicopathological characteristics, and microorganisms identified were reported at 3 months interval and preoperative predictors of febrile UTI were evaluated with Cox regression analysis. Patients were divided into ONB and IC.
Results: The study cohort included 52 patients with ONB and 112 patients with IC. Febrile UTI was diagnosed in 49 (29.9%) patients. Compared to IC group, ONB group had significantly higher incidence of young age (p = 0.00), lower cancer stage (p = 0.013), longer hospital stay (p = 0.049), longer operation time (p = 0.00), and higher incidence of febrile UTI within the first 3 months after surgery (p = 0.006) (Fig 1). On univariable and multivariable analysis, factors associated with significantly increased febrile UTI risk were diabetes (OR: 2.52; p = 0.012) and ONB diversion (OR: 2.573; p = 0.031). Forty-four (89.8%) patients were culture positive. However, significant difference in microorganisms was not detected between patients who underwent ONB or IC diversion.
Conclusions: Diabetes and ONB diversion were associated with higher rate symptomatic UTI following radical cystectomy.
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keywords : urinary tract infections, urinary diversion, cystectomy |
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