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Laser ureteral anastomosis using intraluminal albumin stent in a porcine model
Hua Xie1, Brian S Shaffer, Scott A Prahl
1Oregon Medical Laser Center, Providence St. Vincent Medical Center, Portland, Oregon 97225, USA. hxie@providence.org
Background And Objectives:
We compared ureteral anastomosis using a laser and intraluminal albumin stent with both conventional suturing and laser soldering techniques.
Study Design/Materials And Methods:
Twelve pigs underwent bilateral ureteral anastomoses (N = 24) using one of the three anastomotic methods: (1) laser welding with intraluminal albumin stent (N = 11); (2) with albumin solder (N = 8); and (3) conventional suturing (N = 5). Operative parameters, leakage rate, intrapelvic perfusion pressure, urography, and histology of the anastomoses were examined.
Results:
Operative time for ureteral anastomosis in the stent and solder groups were significantly shorter than the suture group (means 370 seconds and 360 vs. 710 seconds, both P = 0.02). Leakage rate of the anastomoses was lower in the stent group (9%, 1/11) as compared to the solder group (25%, 2/8). The Whitaker test showed that the intrapelvic perfusion pressure elevated gradually after anastomosis and significantly increased at 4 weeks postoperatively in all three methods. Various degrees of hydronephrosis were also noticed in three groups after 4 weeks of surgery.
Conclusions:
Use of the intraluminal albumin stent increased the reliability of laser welding for ureteral anastomosis. The clinical significance of using this technique should be investigated further.
