[Comparison Bricker's and Wallace's anastomoses in ileal conduit: Retrospective, multicenter study]

Area of Science:

• Urology
• Surgical Techniques
• Nephrology

Background:

• Ileal conduit urinary diversion is a common surgical procedure.
• Ureteroenteric anastomosis is a critical step with potential complications like hydronephrosis.
• Bricker and Wallace techniques are the most frequently used methods for ureteroenteric anastomosis.

Purpose of the Study:

• To compare the incidence of hydronephrosis between Bricker and Wallace anastomosis in ileal conduits.
• To identify other risk factors associated with hydronephrosis after ileal conduit surgery.

Main Methods:

• Retrospective study involving 160 patients across two French hospitals.
• Comparison of hydronephrosis rates (complicated and non-complicated) between Bricker and Wallace groups.
• Analysis of risk factors including body mass index, side of surgery, and preoperative hydronephrosis.

Main Results:

• No statistically significant difference in complicated or non-complicated hydronephrosis rates between Bricker (9.9%, 20.6%) and Wallace (10.8%, 13.6%) anastomosis.
• Elevated body mass index (over 25 kg/m²) was significantly associated with complicated hydronephrosis.
• Left-sided surgery and preoperative hydronephrosis were linked to non-complicated hydronephrosis.

Conclusions:

• Both Bricker and Wallace ureteroenteric anastomosis techniques are comparable in terms of hydronephrosis rates.
• High body mass index is a significant risk factor for developing complicated hydronephrosis requiring reoperation.
• Further research may explore strategies to mitigate hydronephrosis risk in obese patients undergoing ileal conduit diversion.