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  • Title: Ureteral complications in renal transplantation: a comparison of the Lich-Gregoir versus the Taguchi technique.
    Author: Lee RS, Bakthavatsalam R, Marsh CL, Kuhr CS.
    Journal: Transplant Proc; 2007 Jun; 39(5):1461-4. PubMed ID: 17580162.
    Abstract:
    OBJECTIVE: Modifications of the Lich-Gregoir extravesical ureteroneocystostomy have become the standard technique for management of the ureter during renal transplantation. We performed a comparative outcome examination of the standard Lich-Gregoir technique and the Taguchi or "one-stitch" technique. METHODS: We reviewed our experience at the University of Washington with the Taguchi (one-stitch, Minnesota) extravesical reimplant technique that involves tacking the distal ureter to the bladder mucosa with a single absorbable stitch. RESULTS: During a 3.5-year period, 330 renal transplants were performed and in 73 cases a Taguchi ureteral anastomosis was employed rather than the Lich-Gregoir technique (238 cases). The overall complication rate for the Taguchi technique was 23% (n = 16) as opposed to 7.1% for the Lich-Gregoir technique. When comparing the Taguchi to the Lich-Gregoir technique, there was a significant increase in hematuria and ureteral complications (P = .002, .012). In a multivariate analysis, the Taguchi technique was a significant risk factor for both hematuria and ureteral complications. CONCLUSIONS: In summary, our limited experience with Taguchi ureteroneocystostomy resulted in dramatically higher complication rates than the modified the Lich-Gregoir technique.
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