MP41-06 A COMPARATIVE STUDY EXAMINING STRICTURE RATES USING A MODIFIED SURGICAL TECHNIQUE FOR URETEROENTERIC ANASTAMOSIS

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion I (MP41)1 Apr 2020MP41-06 A COMPARATIVE STUDY EXAMINING STRICTURE RATES USING A MODIFIED SURGICAL TECHNIQUE FOR URETEROENTERIC ANASTAMOSIS Katherine Cockerill*, Patrick Houghton, Nikhita Yadlapalli, and Paul Young Katherine Cockerill*Katherine Cockerill* More articles by this author , Patrick HoughtonPatrick Houghton More articles by this author , Nikhita YadlapalliNikhita Yadlapalli More articles by this author , and Paul YoungPaul Young More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000890.06AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Benign ureteroenteric anastamotic stricture (UES) can occur in up to 15% of patients after cystectomy with urinary diversion, with a left sided predominance noted in the literature. Surgical repair of left-sided UES can be challenging due to dissection of the ureter over the sacral promontory in close proximity to the pelvic vasculature. The purpose of our study is to examine the effect of a modified operative technique on postoperative UES rate in patients undergoing cystectomy with ileal conduit urinary diversion. METHODS: We examined all patients who underwent cystectomy with ileal conduit urinary diversion by a single surgeon from 2010 to 2019. After January 2016, the procedure was performed using a modified operative technique involving passage of the left ureter through the sigmoid mesentery and an end-to-end anastomosis of the left ureter to the ileal conduit. Prior to 2016, conventional technique involved passage of the left ureter over the sacral promontory with standard Bricker ureteral anastomosis. We evaluated left-sided UES rates using the modified versus the conventional technique. RESULTS: A total of 290 patients underwent cystectomy with ileal conduit urinary diversion by a single surgeon from 2010 to 2019. 223 patients underwent cystectomy for malignancy, and 67 patients underwent cystectomy for nonmalignant purposes. Overall UES rate for 290 patients was 11%. A total of 148 patients underwent the procedure using the modified operative technique, with left-sided UES rate of 10.1% (15/148). A total of 142 patients underwent the procedure using the conventional technique, with left-sided UES rate of 9.9%. CONCLUSIONS: Our modified technique does not appear to change the rate of left-sided UES and we believe this technique makes surgical UES repair more facile. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e597-e597 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Katherine Cockerill* More articles by this author Patrick Houghton More articles by this author Nikhita Yadlapalli More articles by this author Paul Young More articles by this author Expand All Advertisement PDF downloadLoading ...