Short-term outcomes and surgical technique of cecum and appendix-based urinary diversion in radical cystectomy patients: a case series.

Introduction and Importance: Radical cystectomy requires urinary diversion. Although the ileal conduit is the standard approach, it may be contraindicated in certain patients due to prior abdominal surgery, radiation, bowel disease, or anatomical limitations. In such situations, alternative bowel segments, such as the cecum and appendix, may provide a viable option. Evidence regarding the safety and outcomes of cecum-appendix urinary diversion remains limited. Case Presentation: This retrospective case series includes 10 patients who underwent radical cystectomy with cecum-appendix urinary diversion between January and July 2025. The mean age was 69 years, and most patients had significant comorbidities, including chronic kidney disease. Operative time ranged from 80 to 110 minutes. Postoperative recovery was uneventful in most cases, with bowel function returning within 24-48 hours and a mean hospital stay of 4 days. Clinical Discussion: No major complications such as ureteroenteric leaks, strictures, parastomal hernias, metabolic disturbances, or urinary tract infections were observed during short-term follow-up. Renal function and electrolyte balance remained stable. All patients reported satisfactory urinary drainage without stomal dysfunction. These findings suggest that cecum-appendix diversion may reduce bowel manipulation and operative complexity in selected patients when ileal diversion is unsuitable. Conclusion: Cecum-appendix urinary diversion following radical cystectomy appears to be a safe and feasible short-term alternative in carefully selected patients. Larger studies with longer follow-up are required to evaluate long-term functional, metabolic, and oncologic outcomes.