Bricker's ileal conduit urinary diversion with a simple non-refluxing uretero ileal anastomosis.
Fifty consecutive patients had ileal conduits constructed with a technically and quick simple antireflux ureteroileal anastomosis. Complications related to the ureteral implantation were studied retrospectively, and at follow-up (8 months-12 years later, median 3 years) conduit dysfunction and ureteral reflux were assessed in 18 patients out of the 25 patients who were still alive. Early complications and signs of late upper urinary tract deterioration were similar to those found after other operative techniques had been used. One patient had a postoperative urinary leak from the uretero ileal anastomosis. which was treated successfully by two weeks drainage. Hydronephrosis deteriorated in 18 (26%) of the renal units, remained unchanged in 39 (57%) and improved in 11 (16%). Increases in plasma creatinine concentrations up to 200 mumol/l were found in eight patients, and in one patient it increased from 300 to 420 mumol/l. Partial ureteral reflux was present in three (2 patients) of 33 ureters studied and minimal conduit dysfunction was found in 8 patients. In conclusion we find this method of urinary diversion to be quick, easy, and safe.
Bernstein
I T
IT
Department of Urology and Radiology, Hvidovre Hospital, University of Copenhagen, Denmark.
Bennicke
K
K
Rørdam
P
P
Klarskov
P
P
Iversen
H G
HG
D000328:Adult; D000368:Aged; D000714:Anastomosis, Surgical / Q000379:methods*; D015653:Cystectomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006869:Hydronephrosis / Q000517:prevention & control; D007082:Ileum / Q000601:surgery*; D007677:Kidney Function Tests; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D013536:Suture Techniques; D014513:Ureter / Q000601:surgery*; D001749:Urinary Bladder Neoplasms / Q000601:surgery*; D014547:Urinary Diversion / Q000379:methods*; D014549:Urinary Incontinence / Q000601:surgery*; D014563:Urodynamics / Q000502:physiology; D014567:Urography; D014718:Vesico-Ureteral Reflux / Q000517:prevention & control*