Laser ureteral anastomosis using intraluminal albumin stent in a porcine model

Background and Objectives: We compared ureteral anastomosis using a laser and intraluminal albumin stent with both conventional suturing and laser soldering techniques. Study Design/Materials and Methods: Twelve pigs underwent bilateral ureteral anastomoses (N = 24) using one of the three anastomotic methods: (1) laser welding with intraluminal albumin stent (N = 11); (2) with albumin solder (N = 8); and (3) conventional suturing (N = 5). Operative parameters, leakage rate, intrapelvic perfusion pressure, urography, and histology of the anastomoses were examined. Results: Operative time for ureteral anastomosis in the stent and solder groups were significantly shorter than the suture group (means 370 seconds and 360 vs. 710 seconds, both P = 0.02). Leakage rate of the anastomoses was lower in the stent group (9%, 1/11) as compared to the solder group (25%, 2/8). The Whitaker test showed that the intrapelvic perfusion pressure elevated gradually after anastomosis and significantly increased at 4 weeks post-operatively in all three methods. Various degrees of hydronephrosis were also noticed in three groups after 4 weeks of surgery. Conclusions: Use of the intraluminal albumin stent increased the reliability of laser welding for ureteral anastomosis. The clinical significance of using this technique should be investigated further. (C) 2003 Wiley-Liss, Inc.