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Vessel-sparing Excision and Primary Anastomosis
Published on: January 7, 2019
Further experience with split-cuff nipple ureteral reimplantation in urinary diversion
1University of Texas, Southwestern Medical Center, Dallas, USA.
Purpose:
The intermediate followup results with split-cuff nipple ureteral reimplantation in larger numbers of urinary diversion patients are reviewed.
Materials And Methods:
Split-cuff nipple ureteroenteric anastomosis was performed in 98 ureters of 51 adult patients. Mean duration of followup was 23 months (range 3 to 62). Two minor variations in technique compared to the original report are presented.
Results:
Urinary reflux was prevented in 97.6 and 96.8% of cases at 1 and 2-year followup, respectively. Ureteroenteric anastomotic obstruction occurred in 3.1% of ureters by 3 months postoperatively. No cases of anastomotic leak or later obstruction occurred. Four episodes of acute pyelonephritis occurred in the early postoperative period.
Conclusions:
The split-cuff nipple ureteral reimplant technique in urinary diversion continues to provide excellent results with low rates of reflux or obstruction. The 2 described minor technical modifications further simplify the procedure.
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