Safety of Prophylactic Ureteral Stents in Colorectal Surgery: A Systematic Review and Meta-Analysis

Abstract

The association between prophylactic ureteral stents (PUS) and postoperative complications was evaluated. Five electronic databases were searched to identify studies involving patients undergoing colorectal surgery (CRS) with PUS. Primary outcomes were acute kidney injury (AKI), ureteral injury (UI), urinary tract infection (UTI) and hematuria. Risk ratios (RR) and mean differences (MD) were calculated using a random-effects model. Seventeen retrospective cohort studies involving 104 162 patients were analyzed. AKI incidence was not significantly different between PUS and non-PUS (P = .06). Subgroup analysis revealed no significant increase in AKI (P = .08). UI was similar (P = .74); UTI (P < .01) and hematuria (P < .01) were significantly higher with PUS. Operative time was longer (P < .01). PUS in CRS did not significantly reduce UI or increase AKI risk but was associated with higher UTI and hematuria.

Keywords: acute kidney injury; colorectal surgery; ureteral catheter; ureteral injury; ureteral stent.