Evaluation of ureterointestinal anastomosis: Wallace vs Bricker. 2006

Apostolos Evangelidis, and Eugene K Lee, and Michael E Karellas, and J Brantley Thrasher, and Jeffrey M Holzbeierlein
Department of Urology, University of Kansas Medical Center, Kansas City, Kansas 66160, USA. aevangel@kumc.edu

OBJECTIVE There are no published reports to our knowledge comparing the complication rates of the 2 most frequently used ureterointestinal anastomoses. We compared the Bricker method vs the Wallace method in terms of stricture rate. METHODS A retrospective review of the cystectomy database at our institution covering 1997 to 2003 was conducted. Patients were reviewed in terms of type of anastomosis, stricture formation, intervention, radiation therapy, type of diversion, operating room time, sex and age. RESULTS A total of 237 patients at our institution underwent cystectomy during the time evaluated. Of these patients, 33 had incomplete data, 2 were anephric and did not require diversion, and 4 patients underwent LeDuc anastomosis. These patients were excluded from analysis, leaving 198 patients, 86 (43%) undergoing Bricker and 112 (56%) undergoing Wallace. Bricker anastomoses were considered 2 anastomotic units while Wallace anastomoses were considered a single unit. Therefore, there were 162 (59%) total Bricker anastomoses compared to 112 (41%) Wallace anastomoses. There was no statistically significant difference between the 2 groups in terms of type of diversion, number of patients undergoing adjuvant or neoadjuvant radiation therapy, operating room time, and days of followup. There were 3 strictures (1.85%) in the Bricker group and 5 strictures (4.46%) in the Wallace group. There was no statistically significant difference between the stricture rate in these 2 groups (p = 0.21). Stricture rates for patients undergoing neoadjuvant or adjuvant radiation were not statistically significant from the patients with no adjuvant therapy. CONCLUSIONS Overall the stricture rate for ureterointestinal anastomosis was 2.92%. There was no difference in stricture rate between the 2 types of ureterointestinal anastomosis.

UI MeSH Term Description Entries
D007422 Intestines The section of the alimentary canal from the STOMACH to the ANAL CANAL. It includes the LARGE INTESTINE and SMALL INTESTINE. Intestine
D008297 Male Males
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D003251 Constriction, Pathologic The condition of an anatomical structure's being constricted beyond normal dimensions. Stenosis,Stricture,Constriction, Pathological,Pathologic Constriction,Constrictions, Pathologic,Pathologic Constrictions,Pathological Constriction,Stenoses,Strictures
D005260 Female Females
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000368 Aged A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available. Elderly
D000714 Anastomosis, Surgical Surgical union or shunt between ducts, tubes or vessels. It may be end-to-end, end-to-side, side-to-end, or side-to-side. Surgical Anastomosis,Anastomoses, Surgical,Surgical Anastomoses
D012189 Retrospective Studies Studies used to test etiologic hypotheses in which inferences about an exposure to putative causal factors are derived from data relating to characteristics of persons under study or to events or experiences in their past. The essential feature is that some of the persons under study have the disease or outcome of interest and their characteristics are compared with those of unaffected persons. Retrospective Study,Studies, Retrospective,Study, Retrospective
D013520 Urologic Surgical Procedures Surgery performed on the urinary tract or its parts in the male or female. For surgery of the male genitalia, UROLOGIC SURGICAL PROCEDURES, MALE is available. Procedure, Urologic Surgical,Procedures, Urologic Surgical,Surgical Procedure, Urologic,Surgical Procedures, Urologic,Urologic Surgical Procedure,Urological Surgical Procedures,Procedure, Urological Surgical,Procedures, Urological Surgical,Surgical Procedure, Urological,Surgical Procedures, Urological,Urological Surgical Procedure

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