Laser ureteral anastomosis using intraluminal albumin stent in a porcine model.
OBJECTIVE
We compared ureteral anastomosis using a laser and intraluminal albumin stent with both conventional suturing and laser soldering techniques.


METHODS
Twelve pigs underwent bilateral ureteral anastomoses (N = 24) using one of the three anastomotic methods: (1) laser welding with intraluminal albumin stent (N = 11); (2) with albumin solder (N = 8); and (3) conventional suturing (N = 5). Operative parameters, leakage rate, intrapelvic perfusion pressure, urography, and histology of the anastomoses were examined.


RESULTS
Operative time for ureteral anastomosis in the stent and solder groups were significantly shorter than the suture group (means 370 seconds and 360 vs. 710 seconds, both P = 0.02). Leakage rate of the anastomoses was lower in the stent group (9%, 1/11) as compared to the solder group (25%, 2/8). The Whitaker test showed that the intrapelvic perfusion pressure elevated gradually after anastomosis and significantly increased at 4 weeks postoperatively in all three methods. Various degrees of hydronephrosis were also noticed in three groups after 4 weeks of surgery.


CONCLUSIONS
Use of the intraluminal albumin stent increased the reliability of laser welding for ureteral anastomosis. The clinical significance of using this technique should be investigated further.
Xie
Hua
H
Oregon Medical Laser Center, Providence St. Vincent Medical Center, Portland, Oregon 97225, USA. hxie@providence.org
Shaffer
Brian S
BS
Prahl
Scott A
SA
Gregory
Kenton W
KW
D000714:Anastomosis, Surgical / Q000379:methods*; D000818:Animals; D005260:Female; D006801:Humans; D053685:Laser Therapy; D012709:Serum Albumin; D015607:Stents; D013536:Suture Techniques; D013552:Swine; D014513:Ureter / Q000601:surgery*
D012709:Serum Albumin