Comparison of running and interrupted vesicourethral anastomoses in a porcine model.
OBJECTIVE
To compare running and interrupted suturing techniques for porcine vesicourethral anastomosis with regard to procedure time, histopathologic effects, and leakage.


METHODS
Twelve domestic pigs were randomized to a running (N = 6) or an interrupted (N = 6) vesicourethral anastomosis with polyglycolic acid sutures. In each case, the bladder was drained for 7 days. A cystogram was performed immediately after completion of each anastomosis and on postoperative days 7 and 30. Animals were sacrificed on postoperative day 30, and the area of the anastomosis was excised en bloc for histopathologic evaluation.


RESULTS
All procedures were completed laparoscopically. The mean operative time for continuous and interrupted suturing were 27.5 and 36.8 minutes, respectively (P = 0.3324). A significant learning curve was noted for both anastomoses, with operative times decreasing with experience in both groups. There was no difference in anastomotic leakage. Histopathology examination revealed more muscle-layer fibrosis in the interrupted- suture group than in the continuous-suture group, with a mean score of 2.17 and 1.67, respectively (P = 0.0325).


CONCLUSIONS
Both continuous and interrupted vesicourethral anastomoses are feasible. In this in-vivo porcine comparison, there was no difference with respect to procedure time or anastomotic leakage. However, histopathologic grading demonstrated greater muscle fibrosis in the interrupted-suture group.
Lieber
David
D
Division of Urology, Washington University School of Medicine, St. Louis, Missouri, USA.
Tran
Veronique
V
Belani
Jay
J
Ames
Caroline
C
Morissey
Kevin
K
Yan
Yan
Y
Humphrey
Peter
P
Venkatesh
Ramakrishna
R
Landman
Jaime
J
D000714:Anastomosis, Surgical / Q000379:methods; D000818:Animals; D010535:Laparoscopy; D023421:Models, Animal; D011468:Prostatectomy / Q000379:methods; D013552:Swine; D014521:Urethra / Q000601:surgery*; D001743:Urinary Bladder / Q000601:surgery*; D013520:Urologic Surgical Procedures / Q000379:methods