Abstract / Summary
Background: Ureteroenteric stricture is a major late complication following radical cystectomy with ileal conduit diversion. While Bricker and Wallace techniques are widely used, the optimal ureteroileal reconstruction remains debated. The Hybrid ureteroileal anastomosis combines features of both methods, aiming to preserve ureteral vascularity while ensuring independent renal drainage. Aims and Objectives: To compare perioperative and postoperative outcomes of Hybrid versus conventional Bricker/Wallace ureteroileal anastomosis in patients undergoing radical cystectomy with ileal conduit diversion. Materials and Methods: This prospective observational study included 40 patients over 18 months, divided into Hybrid (n=20) and conventional (n=20) groups. The primary outcome was ureteroenteric stricture formation; secondary outcomes included hydronephrosis, urinary tract infection (UTI), secondary intervention, operative time, blood loss, hospital stay, and complications. Statistical significance was set at P<0.05. Results: Baseline characteristics were similar. The Hybrid group showed significantly lower rates of hydronephrosis (10% vs. 30%; P=0.048), stricture (10% vs. 30%; P=0.04), and secondary intervention (10% vs. 30%; P=0.04). Operative time, blood loss, hospital stay, and overall complications were comparable. No anastomotic leaks occurred. UTI was more frequent in the Hybrid group (40% vs. 20%), but not statistically significant (P=0.31). Conclusion: Hybrid ureteroileal anastomosis reduced post-operative hydronephrosis, stricture, and reintervention without increasing operative complexity or morbidity. It appears to be a safe and promising alternative for ureteroenteric reconstruction. Larger multicentric randomized trials with longer follow-up are warranted.