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A modified ureteroileal anastomosis technique for Bricker urinary diversion
Youyuan Li1, Qianyuan Zhuang, Zhiquan Hu
1Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Urology
|September 6, 2011
Summary
A modified Bricker ileal conduit urinary diversion technique reduces ureteroileal anastomotic complications, particularly for the left ureter. This safe and effective method offers an alternative for patients with extensive urothelial carcinoma involving the left distal ureter.
Area of Science:
- Urology
- Surgical Techniques
- Oncology
Background:
- Ureteroileal anastomotic complications occur in up to 10% of patients following Bricker ileal conduit urinary diversion.
- These complications are more prevalent on the left side ureter.
Purpose of the Study:
- To present a modified Bricker ileal conduit technique designed to minimize ureteroileal anastomotic complications, especially those involving the left ureter.
Main Methods:
- The modified technique involves routing the ileal conduit from the right to the left under the mesosigmoid in an isoperistaltic manner.
- The left ureter is anastomosed to the ileal segment in an end-to-side fashion without extensive ureteral dissection, preserving its natural extraperitoneal location.
Main Results:
- Forty-two patients underwent urinary diversion using the modified technique.
- Median follow-up was 18.6 months.
- No major perioperative complications or early/intermediate-term ureteroileal anastomotic complications were observed.
Conclusions:
- The modified technique is easy and safe to perform.
- It serves as a viable alternative to the standard Bricker procedure.
- This method is particularly beneficial for patients with urothelial carcinoma extensively involving the left distal ureter.
