ORIGINAL RESEARCH article
Front. Oncol.
Sec. Surgical Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1613772
This article is part of the Research TopicUrothelial Neoplasms: An Integrated Approach to Prevention, Diagnostics, and Personalized TherapyView all 9 articles
Comparative Analysis of Ureteroileal Anastomotic Stricture Rates: Bricker versus Wallace Techniques in Ileal Conduit Urinary Diversion—A Single-Surgeon Study with BMI-Matched Design and Long-Term Follow-Up Excluding Cancer Recurrence Bias
Provisionally accepted
- 1Department of Urology, Affiliated Hospital of Inner Mongolia Medical University, Hohhot, China, Hohhot, China
- 2Department of Urology, Affiliated People's Hospital, Chongqing University, Chongqing, China, Chongqing, China
- 3Department of Urology, Inner Mongolia Autonomous Region People's Hospital, Hohhot, China, Hohhot, China
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Background: Ureteroileal anastomotic stricture (UIAS) remains a critical complication following ileal conduit urinary diversion for muscle-invasive bladder cancer (MIBC). Despite widespread use of Bricker and Wallace techniques, comparative outcomes remain debated. This study compares stricture rates between these techniques under standardized surgical conditions, controlling for body habitus and without cancer recurrence-related stenosis. Methods: A retrospective analysis included 46 patients undergoing laparoscopic ileal conduit diversion by a single surgeon (2017–2021). Patients were stratified into Bricker (n=18) and Wallace (n=28) groups, matched for BMI and comorbidities. Hydronephrosis severity was graded using the Onen system. Statistical analyses utilized Fisher's exact test, Mann-Whitney U test, and t-test. Results: No significant difference in hydronephrosis incidence was observed (Bricker: 11.1% vs. Wallace: 0%, p=0.148). However, the Bricker group exhibited longer operative time (301.89±11.76 vs. 281.32±10.15 minutes, p<0.001) and hospitalization duration (18.18±8.22 vs. 11.38±5.11 days, p=0.005). All strictures were asymptomatic (Onen Grade 1). Conclusion: Both techniques demonstrate comparable safety regarding stricture rates. Wallace anastomosis offers superior operative efficiency, while Bricker requires additional time for technical precision. This study highlights the importance of standardized surgical protocols and long-term surveillance in optimizing urinary diversion outcomes.
Keywords: Bladder cancer, Urinary Diversion, Bricker technique, Wallace technique, Ureteroileal anastomosis, Stenosis rate
Received: 17 Apr 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Ren, Xiao, Zhu, Tong and Yi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Faxian Yi, Department of Urology, Affiliated People's Hospital, Chongqing University, Chongqing, China, Chongqing, China
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