Fukuta Kyotaro, Nakanishi Ryoichi, Shiozaki Keito, Utsunomiya Seiya, Sasaki Yutaro, Nakashima Takeshi, Fukawa Tomoya, Izaki Hirofumi, Furukawa Junya
Department of Urology Tokushima Prefectural Central Hospital Tokushima Japan.
Department of Urology Tokushima University Graduate School of Biomedical Sciences Tokushima Japan.
IJU Case Rep. 2025 Jun 25;8(5):462-465. doi: 10.1002/iju5.70065. eCollection 2025 Sep.
Bladder cancer in patients with ureteral anomalies presents unique surgical challenges, particularly regarding urinary diversion. This case highlights a novel approach to uretero-ileal anastomosis in a patient with duplicated right ureters undergoing radical cystectomy.
A 65-year-old man with cT2N0M0 bladder cancer underwent transurethral resection of the bladder tumor, revealing a complete duplex right ureter. Following neoadjuvant chemotherapy, he underwent robot-assisted radical cystectomy with intracorporeal ileal conduit construction. The left ureter was anastomosed using the Bricker technique. To optimize right ureteral drainage, slits were made in both ureters, and their medial margins were sutured to form a Wallace plate, which was subsequently anastomosed to the ileal conduit. Ureteral stents were removed successfully after 2 weeks.
One year postoperatively, no urinary diversion-related complications occurred. The uretero-ileal anastomotic technique should be selected based on the case and the surgeon's or institution's experience.
输尿管异常患者的膀胱癌呈现出独特的手术挑战，尤其是在尿流改道方面。本病例突出了一种针对行根治性膀胱切除术的右侧重复输尿管患者进行输尿管-回肠吻合的新方法。
一名患有cT2N0M0膀胱癌的65岁男性接受了经尿道膀胱肿瘤切除术，发现右侧输尿管完全重复。新辅助化疗后，他接受了机器人辅助根治性膀胱切除术并进行体内回肠代膀胱术。左侧输尿管采用布里克技术进行吻合。为优化右侧输尿管引流，在两条输尿管上都做了切口，并将它们的内侧边缘缝合形成一个华莱士板，随后将其与回肠代膀胱吻合。输尿管支架在2周后成功取出。
术后一年，未发生与尿流改道相关的并发症。应根据具体病例以及外科医生或机构的经验选择输尿管-回肠吻合技术。
