Page 5 - AUQ2022Abstracts

RÉSUMÉS AUQ 2022
RÉSUMÉS AUQ 2022

Association des Urologues du Québec Congrès Annuel 2022 – Résumés

Cité comme suit : Can Urol Assoc J 2022;16(12S3):S205-13. http://dx.doi.org/10.5489/cuaj.8204

Session scientifique I
Vendredi 28 octobre 2022

Performing urological inpatient procedures as same-day Secondary malignancies after radiotherapy for prostate cancer:
procedures during the COVID pandemic — a retrospective A population-based study
feasibility study Patricia Quintana Barcena , Armen Aprikian , Alice Dragomir 2,3
2,3
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Siron Nicolas , Anis Assad , Kevin Zorn , Jean-Baptiste Lattouf , Malek 1 Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada;
1,2
1,2
1,2
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Meskawi , Naeem Bhojani 1,2 2 Urology, Department of Surgery, McGill University, Montreal, QC,
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1 Université de Montréal, Montreal, QC, Canada; CHUM, Montreal, QC, Canada; Research Institute of the McGill University Health Centre,
2
Canada Montreal, QC, Canada
Introduction: In line with Canadian provincial directives due to the COVID- Introduction: Survival of prostate cancer (PCa) patients has improved over
19 pandemic, certain urological procedures that are normally performed time thanks to improvement of surgical and radiation therapy (RT) technics.
as inpatient procedures were performed as same-day procedures to reduce Recent evidence has shown that receiving RT may predispose to secondary
the usage of healthcare resources. At our center during the pandemic, we malignancies. This study aimed to assess the risk of secondary malignan-
began performing laser enucleation of the prostate (LEP), robotic-assisted cies in men treated with RT and radical prostatectomy (RP). Those with
radical prostatectomy (RARP), and percutaneous nephrolithotomy (PCNL) as evidence of bladder cancer (BCa) or colorectal cancer (CRCa) prior to PCa
outpatient surgeries. Recent literature has suggested that these procedures diagnosis were excluded.
are safe and feasible as same-day surgeries. Our goal was to determine if Methods: A cohort study was constructed using Quebec administrative data-
there was a difference in patient outcomes in LEP, RARP, and PCNL patients bases (Med-Echo and RAMQ). This included men being diagnosed and
operated as same-day surgery vs. inpatient. treated with RP or RT for PCa patients from 2000–2016. The outcomes of
Methods: Patients operated for LEP, RARP, or PCNL were studied between interest were the incidence of BCa and CRCa. Followup ended at the earli-
May 2020 to March 2022. Among LEP patients, 104 were identified as est of the following: incidence of BCa or of CRCa, death, or December 31,
planned same-day procedures (PSD-LEP) and 65 were planned inpatient 2016. Patients inverse probability treatment weighting (IPTW) based on a
procedures (PIP-LEP). Among RARP patients, 46 were identified as planned propensity score was used to control for potential confounding. IPTW-Cox
same-day procedures (PSD-RARP) and 148 were planned inpatient pro- proportional hazards models were used to evaluate the associations between
cedures (PIP-RARP). AmongPCNL patients, 38 were identified as planned the initial PCa treatment (RT or RP) and the incidence of BCa and CRCa.
same-day procedures (PSD-PCNL) and 12 were planned inpatient proced- Results: The cohort consisted of 15 544 and 27 838 patients treated with
ures (PIP-PCNL). PSD patients were compared to PIP patients for all patient external beam radiation therapy (EBRT) and RP, respectively, without andro-
groups with primary outcomes being SD failure, 30-day complications, gen deprivation therapy. Among these, 118 and 95 patients presented evi-
and readmission rates. dence of BCa and CRCa, respectively, and were excluded for the analyses.
Results: General patient characteristics, such as age, American Society of Mean age was 70 years old in the RT group and 64 years old in the RP group.
Anesthesiologist classification, and Revised Cardiac Risk Index (RCRI) were In the weighted cohorts, patients treated with RT exhibited a significant
similar between PSD and PIP in both patient populations. Of the PSD-LEP increased risk of CRCa (HR 1.27, 95% CI 1.13–1.43), and of BCa (HR 1.78,
patients, 77.9% were successfully discharged the day of the surgery. The 95% CI 1.54–2.07) compared to men treated with RP.
overall postoperative complication, 30-day ED visits, and readmission rates Conclusions: Our study confirmed that men undergoing RT for PCa had
were 8.7%, 3.8%, and 1.0 %, respectively, for PSD-LEP patients vs. 23 % an increased risk of secondary BCa and CRCa compared to patients under-
(p=0.017), 9.2% (p=0.27), and 4.6% (p=0.32), respectively, for PIP-LEP going RP.
patients. Of the PSD-RARP patients, 73.9% were successfully discharged
the day of the surgery. The overall postoperative complication, 30-day ED The association of cortical transit time with diuretic drainage time
visits, and readmission rates were 15.2%, 17.4%, and 4.3%, respectively, parameters in antenatal hydronephrosis
for PSD-RARP patients vs. 6.1% (p =0.097), 4.1% (p <0.05), and 1.4% Ioana Fugaru , Richard Liu , Alexa Ehlebracht , Sophie Turpin , Roman
1
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(p=0.51), respectively, for PIP-RARP patients. Of the PSD-PCNL patients, Jednak , Mohammed El-Sherbiny , John-Paul Capolicchio 1
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71.1% were successfully discharged the day of the surgery. The overall 1 Division of Urology, Departments of Pediatric Surgery and Surgery,
postoperative complication, 30-day ED visits, and readmission rates were Montreal Children’s Hospital, McGill University, Montreal, QC, Canada;
21.1%, 7.9%, and 2.6 % respectively, for PSD-PCNL patients vs. 16.7% 2 Division of Nuclear Medicine, Department of Radiology, Montreal
(p=1.0), 8.3% (p=1.0), 8.3% (p=1.0), respectively, for PIP-PCNL patients. Children’s Hospital, McGill University, Montreal, QC, Canada; McGill
3
Conclusions: Same-day discharge for LEP, RARP, and PCNL is safe and Faculty of Medicine, Montreal, QC, Canada
feasible in select patients with an acceptable and comparable complica- Introduction: There are no clear criteria that define obstruction in the
tion rate. context of antenatal hydronephrosis (AHN). Diuretic renogram determines
the differential renal function (DRF), T1/2, and global washout (GWO),
and can assist clinicians in their assessment. Cortical transit time (CTT) is
another parameter that can aid in decision-making in AHN. Our primary
objective is to determine the association of various CTT cutoffs, alone or
in combination with T1/2 and GWO, with patient management.
Methods: We retrospectively reviewed 296 charts. We included 64 con-
secutive pyeloplasties (treatment group), who presented from 2010–2021,
and 44 conservatively managed AHN with diuretic renogram (conserva-
tive group) from 2010–2016. Excluded were 55 patients >12 months old
and 133 patients with other urinary abnormalities/incomplete data. Initial
CUAJ • Décembre 2022 • volume 16, numéro 12S3 S205
© 2022 Association des urologues du Canada