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Techniques for uretero-intestinal reimplantation
Christoph Wiesner1, Joachim W Thüroff
1Department of Urology, Johannes Gutenberg-University, School of Medicine, Langenbeckstrasse 1, 55131 Mainz, Germany. wiesner@urologie.klinik.uni-mainz.de
Current Opinion in Urology
|January 1, 2005
Summary
Uretero-intestinal reimplantation techniques for urinary diversion are debated. Current methods have complications, and a gold standard for uretero-intestinal anastomosis is still needed.
Area of Science:
- Urology
- Surgical Techniques
- Renal Function Preservation
Background:
- Uretero-intestinal reimplantation is vital for urinary diversion.
- Established techniques aim to minimize complications and preserve kidney function.
Purpose of the Study:
- Review current experiences with uretero-intestinal reimplantation in various urinary diversion types.
- Discuss complications and alternative surgical procedures.
Main Methods:
- Review of existing literature on uretero-intestinal reimplantation techniques.
- Analysis of complications associated with refluxing and nonrefluxing anastomoses.
Main Results:
- Controversy exists regarding basic principles of uretero-intestinal reimplantation.
- Complications include pyelonephritis and calculus formation from reflux, and strictures leading to hydronephrosis from nonrefluxing techniques.
- Alternative methods involve reimplantation into specific ileal segments to leverage the ileocecal valve for reflux prevention.
Conclusions:
- No definitive "gold standard" for uretero-intestinal anastomosis in urinary diversion.
- Further randomized trials are necessary to determine optimal techniques for different diversion types.