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. 2024 Apr;54(4):291-309.
doi: 10.1007/s00595-022-02639-9. Epub 2023 Jan 2.

Preventing iatrogenic ureteral injury in colorectal surgery: a comprehensive and systematic review of the last 2 decades of literature and future perspectives

Pier Paolo Brollo  1   2 , Alessandro Puggioni  3 , Francesco Tumminelli  3   4 , Antonio Colangelo  3   4 , Carlo Biddau  4 , Vittorio Cherchi  3 , Vittorio Bresadola  3
Affiliations

Preventing iatrogenic ureteral injury in colorectal surgery: a comprehensive and systematic review of the last 2 decades of literature and future perspectives

Pier Paolo Brollo et al. Surg Today. 2024 Apr.

Abstract

Iatrogenic ureteral injury (IUI) during colorectal surgery is a rare complication but related to a serious burden of morbidity. This comprehensive and systematic review aims to provide a critical overview of the most recent literature about IUI prevention techniques in colorectal surgery. We performed a comprehensive and systematic review of studies published from 2000 to 2022 and assessed the use of techniques for ureteral injury prevention and intraoperative localization. 26 publications were included, divided into stent-based (prophylactic/lighted ureteral stent and near-infrared fluorescent ureteral catheter [PUS/LUS/NIRFUC]) and fluorescent dye (FD) groups. Costs, the percentage and number of IUIs detected, reported limitations, complication rates and other outcome points were compared. The IUI incidence rate ranged from 0 to 1.9% (mean 0.5%) and 0 to 1.2% (mean 0.3%) in the PUS/LUS/NIRFUC and FD groups, respectively. The acute kidney injury (AKI) and urinary tact infection (UTI) incidence rate ranged from 0.4 to 32.6% and 0 to 17.3%, respectively, in the PUS/LUS/NIRFUC group and 0-15% and 0-6.3%, respectively, in the FD group. Many other complications were also compared and descriptively analyzed (length-of-stay, mortality, etc.). These techniques appear to be feasible and safe in select patients with a high risk of IUI, but the delineation of reliable guidelines for preventing IUI will require more randomized controlled trials.

Keywords: Colorectal surgery; Fluorescence-guided surgery; Iatrogenic ureteral injury; Minimally invasive surgery; Ureteral stent.

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References

    1. Palaniappa NC, Telem DA, Ranasinghe NE, Divino CM. Incidence of iatrogenic ureteral injury after laparoscopic colectomy. Arch Surg. 2012;147(3):267–71. https://doi.org/10.1001/ARCHSURG.2011.2029 . - DOI - PubMed
    1. Andersen P, Andersen LM, Iversen LH. Iatrogenic ureteral injury in colorectal cancer surgery: a nationwide study comparing laparoscopic and open approaches. Surg Endosc. 2015;29(6):1406–12. https://doi.org/10.1007/S00464-014-3814-1 . - DOI - PubMed
    1. Halabi WJ, Jafari MD, Nguyen VQ, Carmichael JC, Mills S, Pigazzi A, et al. Ureteral injuries in colorectal surgery: an analysis of trends, outcomes, and risk factors over a 10-year period in the United States. Dis Colon Rectum. 2014;57(2):179–86. https://doi.org/10.1097/DCR.0000000000000033 . - DOI - PubMed
    1. Marcelissen TAT, den Hollander PP, Tuytten TRAH, Sosef MN. Incidence of iatrogenic ureteral injury during open and laparoscopic colorectal surgery: a single center experience and review of the literature. Surg Laparosc Endosc Percutan Tech. 2016;26(6):513–5. https://doi.org/10.1097/SLE.0000000000000335 . - DOI - PubMed
    1. Mayo JS, Brazer ML, Bogenberger KJ, Tavares KB, Conrad RJ, Lustik MB, et al. Ureteral injuries in colorectal surgery and the impact of laparoscopic and robotic-assisted approaches. Surg Endosc. 2021;35(6):2805–16. https://doi.org/10.1007/S00464-020-07714-1 . - DOI - PubMed

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