Anastomosi intestinali in urologia. Tecniche a confronto

Background. Three different intestinal anastomosis were compared during reconstructive urologic surgery; time, cost and incidence of complications were evaluated. Methods. From November 1993 to February 1997, 45 patients (43 males and 2 females) were submitted to ileal resection to fashion 30 ileal neobladder, 8 ileal conduits and 7 augmentation ileocystoplasties. The patients were randomized in 3 groups. In the first group the intestinal continuity was performed by BAR; the second one was treated by GIA stapling device; the last underwent a manual suture with interrupted stitches double layer (vicryl). Results. The mean follow-up was 18 months. The mean time of canalization was 6.3 days. The complications were: one intestinal subocclusion (group 1); one abdominal wound infection (group 2); one anastomotic leak and one pulmonary embolism (group 3). The mean time of anastomosis was 18, 12 and 39 minutes respectively. The average total cost was 915,000 lire in group 1; 1,280,000 lire in group 2; 632,000 lire in group 3. Conclusions. The conclusion is drawn that mechanical devices (BAR and Stapler) are more convenient and advisable in reconstructive urologic surgery, for their quickness, effectiveness and final total cost.