Abstract
Background
To compare the outcomes of Wallace and Bricker anastomosis techniques in urinary diversion following radical cystectomy for bladder cancer.
Methods
A prospective study was conducted on 50 patients undergoing radical cystectomy with ileal conduit diversion. Patients were randomized into 2 groups: Wallace anastomosis (n = 25) and Bricker anastomosis (n = 25). The primary endpoints included operative time, anastomotic leakage, stricture formation, urinary tract infections (UTI), and long-term renal function.
Results
Operative Time: The mean operative time was significantly lower in the Bricker group (P < .05). Anastomotic Leakage: Wallace group showed a slightly higher, but statistically insignificant, incidence of early leakage (12% vs 8%). Stricture Formation: Stricture rates were comparable between the groups (Wallace: 8%, Bricker: 4%). UTI Rates: Postoperative UTIs were more frequent in the Bricker group (36% vs 28%). Renal Function: No significant long-term deterioration in renal function was observed in either group.
Conclusions
Both Wallace and Bricker anastomosis techniques are viable options for ileal conduit urinary diversion. Wallace anastomosis may have a slightly higher leakage rate, but it does not significantly affect long-term outcomes. The Bricker technique demonstrated a shorter operative time, making it preferable in high-risk patients. Further large-scale studies are required to establish definitive recommendations.