Dr Son on Urinary and Bowel Anastomotic Leak in Bladder Cancer

Young Son, PGY3, Jefferson NJ Urology, discusses the future implications of findings from a study investigating the association between neoadjuvant chemotherapy and increased urinary and bowel anastomosis failure in patients with bladder cancer who are undergoing radical cystectomy.

In the total population of patients observed in this study, 3.92% of patients who had received neoadjuvant chemotherapy and radical cystectomy had a bowel anastomosis leak, and 4.89% of the patients in this cohort had a urinary anastomosis leak. Additionally, 2.44% of patients who had received neoadjuvant chemotherapy and radical cystectomy had a bowel anastomosis leak requiring intervention.

Dr Son on the Incidence of Bowel and Urinary Anastomosis Leak in Bladder Cancer

Bowel and urinary anastomosis leaks are devastating complications associated with bladder cancer, especially in patients who are symptomatic and require interventional radiology or additional time in the operating room, according to Son. Identifying and correcting urinary and bowel anastomosis leak, as well as distinguishing risk factors associated with this complication may decrease its incidence and severity in patients with bladder cancer, Son says. Communicating with patients who receive neoadjuvant chemotherapy before radical cystectomy about their increased risk for urinary or bowel anastomosis leak is crucial, Son emphasizes.

Dr Son on Potential Risk Factors for Anastomotic Leak in Bladder Cancer

This study’s assessment of independent variables associated with bowel and urinary anastomotic leak showed an association between bowel leak and factors including hypertension requiring medication, unplanned readmissions, and unplanned reoperations. Furthermore, patients with urinary anastomotic leak were more likely to develop sepsis after radical cystectomy. Although this was a retrospective study and the correlations between anastomotic leak and comorbidities and adverse effects do not represent definite causality, these potential risk factors are important to consider, and surgeons should take caution if their patients with bladder cancer have these comorbidities, Son concludes.