Increasing numbers of ureteric injuries after the introduction of laparoscopic surgery

Parpala-Spårman, Teija; Paananen, Ilkka; Santala, Markku; Ohtonen, Pasi; Hellström, Pekka

doi:10.1080/00365590802025857

Cited by 145 publications

(93 citation statements)

References 19 publications

(27 reference statements)

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“…It has been reported that iatrogenic ureteral injuries in laparoscopic surgery are less frequently discovered intraoperatively compared with open surgery [22]. Our study does not confirm this observation.…”

Section: Discussioncontrasting

confidence: 70%

Iatrogenic ureteral injury in colorectal cancer surgery: a nationwide study comparing laparoscopic and open approaches

Andersen

Iversen

2014

Surg Endosc

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Section: Discussioncontrasting

confidence: 70%

Iatrogenic ureteral injury in colorectal cancer surgery: a nationwide study comparing laparoscopic and open approaches

Andersen

Iversen

2014

Surg Endosc

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“…The literature data regarding this issue is conflicting. In some studies, the highest incidence has been found with abdominal hysterectomies (17,18), but others reported a higher incidence with laparoscopic hysterectomies (19,20). In contrast, in a prospective study by Ibeanu et al (7), the authors reported that the vaginal hysterectomy was associated with more ureteric injuries (2.6%) than abdominal (1.7%) and laparoscopically assisted vaginal hysterectomies (0%), in accordance with our experience.…”

Section: Discussioncontrasting

confidence: 48%

Urinary Tract Injury at Gynecological Surgery: Results from a Tertiary-Care Institution

Toptaş

Uysal

Karataş

et al. 2017

Gynecol Obstet Reprod Med

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OBJECTIVE:To identify clinical features of urinary tract injuries detected during or after gynecologic surgeries, with a specific focus on incidence and role of surgeon and surgical route on urinary injury. STUDY DESIGN:The institutional database from January 2009 to January 2017 was reviewed with respect to gynecologic (non-obstetric) surgeries and urinary injuries. RESULTS:A total of 8719 gynecologic surgeries were identified. Of these, 46 (0.52%) were found to be complicated with a bladder (n=34, 0.38%), ureteral (n=11, 0.12%) and/or urethral injury (n=1, 0.01%). Bladder injuries occurred mostly at the superior part of the bladder, while ureteric injuries at the most distal part of the ureter. Ureteric injuries were mostly delayed (81.8% vs. 5.9%, p<0.001) and were more related to thermal injury than bladder injuries (45.5% vs. 8.8%, p=0.029). Among all surgical procedures, radical hysterectomy had the highest incidence for the ureteric injury (8.53%), while Burch colposuspension via minimally invasive route had the highest incidence for the bladder injury (16.6%). Cumulative incidence of urinary injury significantly differed according to the surgical route preferred (p=0.032), with the vaginal surgeries were associated with the highest incidence (0.96%). However, there was no such a difference in injury rates between the low-volume (0.55%) and high-volume (0.52%) surgeons (p=0.328) CONCLUSION: Overall incidence of lower urinary tract injury at gynecologic surgeries is low, does not differ according to annual number of surgeries performed, but increases with the vaginal surgeries.

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“…Endometriosis rarely involves the upper urinary tract, (1-2 % of all cases of stenosis), 84 % of which are associated with concomitant bladder involvement [3,4]. The incidence of iatrogenic ureteral injury ranges between 0.1 % and 2.5 % of all the surgical procedures [5,6]; during recent years, an increasing incidence of iatrogenic strictures has been observed, due to the widespread diffusion of abdominal and gynaecological laparoscopic surgery and upper urinary tract endoscopy [7].…”

Section: Introductionmentioning

confidence: 99%

Laparoscopic and robotic ureteral stenosis repair: a multi-institutional experience with a long-term follow-up

et al. 2016

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The treatment of ureteral strictures represents a challenge due to the variability of aetiology, site and extension of the stricture; it ranges from an end-to-end anastomosis or reimplantation into the bladder with a Boari flap or Psoas Hitch. Traditionally, these procedures have been done using an open access, but minimally invasive approaches have gained acceptance. The aim of this study is to evaluate the safety and feasibility and perioperative results of minimally invasive surgery for the treatment of ureteral stenosis with a long-term follow-up. Data of 62 laparoscopic (n = 36) and robotic (n = 26) treatments for ureteral stenosis in 9 Italian centers were reviewed. Patients were followed according to the referring center's protocol. Laparoscopic and robotic approaches were compared. All the procedures were completed successfully without open conversion. Average estimated blood loss in the two groups was 91.2 ± 71.9 cc for the laparoscopic and 47.2 ± 32.3 cc for the robotic, respectively (p = 0.004). Mean days of hospitalization were 5.9 ± 2.4 for the laparoscopic group and 7.6 ± 3.4 for the robotic group (p = 0.006).No differences were found in terms of operative time and post-operative complications. After a median followup of 27 months, the robotic group yielded 2 stenosis recurrence, instead the laparoscopic group shows no cases of recurrence (p = 0.091). Minimally invasive approach for ureteral stenosis is safe and feasible. Both robotic and pure laparoscopic approaches may offer good results in terms of perioperative outcomes, low incidence of complications and recurrence.

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Increasing numbers of ureteric injuries after the introduction of laparoscopic surgery

Cited by 145 publications

References 19 publications

Iatrogenic ureteral injury in colorectal cancer surgery: a nationwide study comparing laparoscopic and open approaches

Iatrogenic ureteral injury in colorectal cancer surgery: a nationwide study comparing laparoscopic and open approaches

Urinary Tract Injury at Gynecological Surgery: Results from a Tertiary-Care Institution

Laparoscopic and robotic ureteral stenosis repair: a multi-institutional experience with a long-term follow-up

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