The Analysis Of Three Types Of Ureteral-ileal Anastomosis In Radical Cystectomy+bricker Ileal Bladder Operation

Objective:To compare and analyze the effect of ureteral-ileal wall tunnel anastomosis,ureteral lumens-ileal end-to-end anastomosis and ureter-ileal papillary anastomosis in radical bladder resection+ Bricker ileal bladder surgery.The selection of the best ureter-ileal anastomosis in ileectomy and ileal bladder surgery provides reference basis.Methods:A retrospective analysis was performed on 75 patients who underwent radical cystectomy+Bricker ileal bladder surgery from January 2005 to December 2019 in our hospital’s urology department.All patients were pathologically diagnosed as urothelial carcinoma after surgery.International Cancer Society(UICC)staging of bladder cancer TNM.According to different ureter-ileal anastomosis,all patients were divided into group A(ureter-ileal tunnel anastomosis)24 cases(48 ureters);group B(ureter combined with lumen-ileal end anastomosis)16 cases(32 ureters));Group C(ureter-ileal papillary anastomosis)35 cases(70 ureters).Compare and analyze the gender,age,operation time(min),intraoperative blood loss(ml),ureter-intestinal anastomosis time(min),surgical method(laparoscopy,traditional open type),and tumor staging of the three groups of patients;Follow-up was performed from 3 months to 60 months after operation,and complications such as anastomotic stenosis,hydronephrosis,pyelonephritis,urinary fistula and stone formation were observed.Results:There were no statistical differences in gender,age,operation time(min),intraoperative blood loss(ml),postoperative pyelonephritis,urinary fistula and calculus formation in the three groups of patients(all P>0.05).The B component of TNM staging of tumors was significantly higher than that of group A(P<0.05);the average ureter-intestinal anastomosis time was more in group B(21.25±3.59)min than group A(12.88±3.69)min,and group A was larger than group C Average time(6.74±1.95)min(both P<0.05);the amount of bleeding in open surgery was greater than that in laparoscopic surgery(P<0.05);ureteral stenosis and hydronephrosis in group A were significantly more than those in groups B and C(All P<0.05).Conclusion:1.Ureteral-ileal wall nipple anastomosis is easy to operate,has a certain anti-reflux effect,and the long-term effect is reliable.2.The ureteral and ileal-ileal end-end anastomosis operation takes a long time,but it has a good effect in protecting kidney function,keeping the urinary tract smooth,and preventing stones from accumulating at the anastomosis.