External stoma and peristomal complications following radical cystectomy and ileal conduit diversion: a systematic review.

摘要: An ileal conduit is the most common urinary diversion following radical cystectomy for invasive bladder cancer. Unlike internal complications commonly described in urological literature, reports about incidence of external are sparse. A Medline database review (1996-2008) English-language literature was conducted to: 1) describe and compare stoma peristomal complication rates among outpatients with cystectomy, 2) summarize used prevention management strategies. Fourteen publications (mostly retrospective, single-center studies) met inclusion criteria. The reported ranged from 15% to 65%. Divided according pathogenesis, or abdominal wall-related changes--parastomal hernia, prolapse, stenosis, retraction; skin changes--chemical injury: irritant contact dermatitis, pseudoverrucous lesions, alkaline crustations; mechanical pressure ulcers, stripping injuries, mucocutaneous separation; infection: candidiasis, folliculitis; immunologic disorders: allergic dermatitis; disease-related lesions: varices, pyoderma gangrenosum, malignancy. Peristomal also appear be under-recognized under-reported. Research establish validity reliability assessment tools long-term follow-up studies needed improve evidence-base care.