title: [Results of the modification of antireflux subserosal and submucosal implantation of the ureter into the rectosigmoid urinary reservoir after total cystectomy].
abstract: BACKGROUND
  Uretero-intestinal anastomisis has a large influence on derivation quality.
  
  
  OBJECTIVE
  The aim of the study was to present the modified serous lined extramural Abol-Enein method of implantation of low quality ureter into the sigma-rectum pouch and comparison of the results with Le Duc implantation.
  
  
  METHODS
  From 1995 to 2009, 62 dilated ureter units were implanted in the detubularized rectosigmoid urinary reservoir. In 28 units Le Duc, and in 34 Abol-Enein method was done. Urinary fistula and ileus were considered as early complications, while late complications included stenosis and reflux pyelonephritis. Frequency of urination was considered as a parameter of functionality.
  
  
  RESULTS
  Transitory urine fistulae occurred only in the ureters implanted according to Le Duc technique in 4/28 (14.2%); the difference between the examined groups was close but still below the level of statistical significance (p = 0.07). Iieus occurred with nearly equal frequency in both groups. Stenosis on the ureteral implantation place was significantly more frequent (p = 0.04) in the Le Duc group 5/28 (21.7%) than in the Abol-Enein group 0/34 (0%). Refluxive pyelonephritis occurred in 3/34 (8.8%) of the Abol-Enein group, and in 5/28 (21.7%) of patients in the Le Duc group. Concerning the daily frequency, there was no difference between the examined groups.
  
  
  CONCLUSIONS
  Uretero-intestinal anastomisis of dilated ureters through a serous-lined extramural tunnel decreases the risk of reflux in a considerable number of patients, with an acceptable level of complications. There are several advantages in comparison with Le Duc method.
authors: Ivica
authors: I
authors: Stojković
authors: Ivan
authors: I
authors: Ignjatović
authors: Dragoslav
authors: D
authors: Bašić
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D006801:Humans; D008875:Middle Aged; D014513:Ureter / Q000601:surgery*; D014547:Urinary Diversion; D016476:Urinary Reservoirs, Continent; D013520:Urologic Surgical Procedures / Q000009:adverse effects