Ureteral complications in renal transplantation: a comparison of the Lich-Gregoir versus the Taguchi technique.
OBJECTIVE
Modifications of the Lich-Gregoir extravesical ureteroneocystostomy have become the standard technique for management of the ureter during renal transplantation. We performed a comparative outcome examination of the standard Lich-Gregoir technique and the Taguchi or "one-stitch" technique.


METHODS
We reviewed our experience at the University of Washington with the Taguchi (one-stitch, Minnesota) extravesical reimplant technique that involves tacking the distal ureter to the bladder mucosa with a single absorbable stitch.


RESULTS
During a 3.5-year period, 330 renal transplants were performed and in 73 cases a Taguchi ureteral anastomosis was employed rather than the Lich-Gregoir technique (238 cases). The overall complication rate for the Taguchi technique was 23% (n = 16) as opposed to 7.1% for the Lich-Gregoir technique. When comparing the Taguchi to the Lich-Gregoir technique, there was a significant increase in hematuria and ureteral complications (P = .002, .012). In a multivariate analysis, the Taguchi technique was a significant risk factor for both hematuria and ureteral complications.


CONCLUSIONS
In summary, our limited experience with Taguchi ureteroneocystostomy resulted in dramatically higher complication rates than the modified the Lich-Gregoir technique.
Lee
R S
RS
Department of Urology, Children's Hospital Boston, Boston, MA, USA.
Bakthavatsalam
R
R
Marsh
C L
CL
Kuhr
C S
CS
D000328:Adult; D003559:Cystostomy / Q000379:methods*; D005260:Female; D006417:Hematuria / Q000209:etiology; D006801:Humans; D016030:Kidney Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis; D012086:Reoperation; D015607:Stents; D014515:Ureteral Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery