SynthesisInternational braz j urol : official journal of the Brazilian Society of Urology
New Evidence on an Old Question: a Meta-Analysis of Wallace versus Bricker Anastomoses.
Synthesis in International braz j urol : official journal of the Brazilian Society of Urology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Robot-Assisted Sigmoid Colon Conduit for Urinary Diversion: Avoiding Bowel Anasto-mosis in a Patient with Prior Loop Colostomy and Pelvic Radiation.International braz j urol : official journal of the Brazilian Society of UrologyArticle
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Authors and funding
12 authors.
Funding
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Abstract
purposeThis meta-analysis compares the efficacy and safety of the Bricker and Wallace techniques, focusing on updating previously unassessed clinical outcomes to inform surgical decision-making. MATERIAL AND
methodsA systematic review and meta-analysis followed PRISMA and Cochrane guidelines, with the protocol in PROSPERO (CRD42024621076). Searches in MEDLINE/PubMed, EMBASE, and Cochrane Library included Randomized Clinical Trials and cohort studies comparing both anastomosis techniques. Analyses used Odds Ratio (OR) and mean differences with a random-effects model.
resultsFourteen studies with 1,903 patients (980 Bricker; 923 Wallace) were included. No significant difference was found in overall stricture rates. However, the Bricker technique had more unilateral strictures (OR 0.47; 95% CI 0.30-0.75; p < 0.01), while the Wallace technique had lower stricture rates in patients who underwent ileal-conduit urinary diversion (OR 0.35; 95% CI 0.19-0.64; p < 0.001), and patients without prior radiotherapy (OR 0.29; 95% CI 0.14-0.61; p < 0.001). Wallace also presented reduced hydronephrosis (OR 0.37; 95% CI 0.17-0.79; p < 0.05). No significant differences were observed in patients undergoing neobladder diversion or those with bladder cancer.
conclusionNo difference in main analyses of stricture rates was found, supporting that technique choice should rely on surgeon preference and expertise. Therefore, beyond surgeon preference, the choice of technique should consider the patient's history of radiotherapy, and the type of urinary diversion planned, aiming to optimize postoperative outcomes and minimize the risk of specific complications.
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