Antireflux Uretero-Intestinal Anastomosis—Flap-and-Trough Technique—Applicable to Ileum: Early Clinical Experience

To report our functional results of the “flap-and-trough” (FT) antireflux uretero-intestinal anastomosis (UIA) applied to various forms of urinary diversions. From April 1998 through March 2003, a total of 49 ureters were implanted in 28 patients into various types of urinary diversions. Forty-six u...

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Bibliographic Details
Published in:European urology 2004-11, Vol.46 (5), p.598-603
Main Authors: DOLEZEL, Jan, SUTORY, Martin, NAVRATIL, Pavel
Format: Article
Language:English
Subjects:
Adult
Aged
Anastomosis, Surgical - methods
Biological and medical sciences
Female
Humans
Ileum - surgery
Kidney transplantation
Male
Medical sciences
Middle Aged
Nephrology. Urinary tract diseases
Surgical Flaps
Treatment Outcome
Uretero-intestinal anastomosis
Urinary Bladder Diseases - surgery
Urinary diversion
Urinary Diversion - methods
Vesico-Ureteral Reflux - prevention & control
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Summary:To report our functional results of the “flap-and-trough” (FT) antireflux uretero-intestinal anastomosis (UIA) applied to various forms of urinary diversions. From April 1998 through March 2003, a total of 49 ureters were implanted in 28 patients into various types of urinary diversions. Forty-six ureters were implanted transluminally (32 separately, 14 conjointly by the double-barrelled method), 3 ureters extraluminally into preformed reservoirs during kidney transplantation. Forty-one ureters were implanted primarily, 8 ureters secondarily due to stricture of former UIA. Median observation time was 26 months. The healing was uneventful in all cases. Late complications were not related to the UIA. Twenty-four patients could be evaluated. The upper urinary tract remained stable, no reflux and no stenosis at the site of UIA were detected. FT anastomoses were clearly seen and easily accessible at endoscopy. In our hands the FT anastomosis has proved to be simple, safe and highly effective in terms of protecting the upper urinary tract against obstruction and reflux. Creation of antireflux UIA need not mean increased risk of obstruction in comparison with direct (reflux) ones. The FT technique could represent another alternative of nonrefluxing implantation of normal as well as dilated ureters into various types of urinary diversion.
ISSN:0302-2838
1873-7560
DOI:10.1016/j.eururo.2004.06.018