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Introduction
Various techniques have been described for uretero-ileal anastomosis (UIA) during urinary diversion following radical cystectomy.Complications related to the technique can lead to significant morbidity in post operative period.
Material and Methods
We retrospectively audited the complications related to uretero ileal anastomosis following continuous and interrupted suturing from our database.
Results
Between 01/01/2013 and 31/12/2016 185 patients underwent open radical cystectomy and urinary diversion for bladder cancer. 362 uretero-ileal anastomosis were done in 185 patients. 198 patients underwent interrupted suturing and 164 patients underwent continuous suturing. All anastomosis were done using absorbable monofilament/polyfilament sutures with sizes 4-0 or 5-0 and were stented. Patients had a median follow up of 16 months (range 1-46). Amongst 198 UIA done by interrupted suturing, 12 (6%) developed a urinary leak. Out of these 6 were managed conservatively and 6 required explorations for re-anastomosis. 1 interrupted UIA developed stricture. 164 UIA were done using continuous technique. Stricture developed in 10 (6%) and leak in 3 (1.82%).One out of these 3 patients required re-exploration in the continuous group for leak.
Conclusion
Both techniques of suturing have their complications. In our series, leaks were more common with interrupted suturing whereas strictures were more common with continuous suturing.