To describe and illustrate a novel technique of uretero-ileal anastomosis for use in urinary diversion – the Pull-through Anastomosis of Ureters to Enteric Conduit (PAUTEC). A second objective was to evaluate the surgical outcomes of the PAUTEC anastomosis.
Our novel anastomotic technique was described step-by-step and visually depicted with illustrations and the accompanying narrated video. Additionally, to evaluate safety and efficacy, a retrospective review of a prospectively maintained database was performed. Patients who underwent radical cystectomy alone or during pelvic exenteration, with ileal conduit diversion incorporating PAUTEC, 2016-2020 with ≥6 months follow-up were included. Surgical outcomes and renal function were analysed.
PAUTEC anastomosis was performed on 43 ureters in 23 patients. Mean age was 66 years [50-80] and 21/23 patients were male. One patient had a conservatively-managed small urine leak. No ureteric strictures have been identified to date. Mean serum creatinine was 1.15mg/dL [0.69-2.08] (96umol/L, range 61-184umol/L) pre-operatively, and 1.09 mg/dL [0.61-2.59] (96.3umol/L, range 54-229umol/L) at follow-up, demonstrating no significant change (p=0.26, paired t-test). Mean follow-up was 15 months [6-44].
A PAUTEC technique of uretero-ileal anastomosis is feasible and technically straightforward, with satisfactory outcomes observed to date.

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