Prophylactic pre-operative bilateral ureteric catheters for major gynaecological surgery

Merritt, Anita J.; Crosbie, Emma J.; Charova, Judith; Achiampong, Josephine Y.; Zommere, Ilze; Winter-Roach, Brett; Slade, Richard J

doi:10.1007/s00404-013-2853-5

Cited by 26 publications

(20 citation statements)

References 23 publications

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“…Others do not find any clear benefit of using ureteric catheters. 13 In our study 23.4% ureteric injury patients had prophylactic ureteric catheterization. Injury forms were complete transection in 61%; ligation in 7%; partial transection in 3% and excision in 29%.…”

Section: Discussionmentioning

confidence: 61%

“…Postoperative complications involving the urinary tract which included urinary tract infection (UTI) (5/337 patients, 1.48 %), acute renal failure (2/337, 0.6%), and ureterovaginal fistulae (1/337 patients, 0.3%) 6% ureteral stricture after ureteroneocystostomy. 13 Selzman et al reported that ureterovaginal fistulas resolved in all seven patients treated with an internal ureteral stent. 1 Tanagho et al found that after persistent reflux, five patients experienced progressive renal deterioration.…”

Section: Discussionmentioning

confidence: 94%

“…12 Ureteric injury occurs in radical Wertheim hysterectomies (1-30%). 13 Hoffman et al reported a 2.2% incidence with radical total hysterectomies, 2.4% for rectosigmoid colectomy 2 radical hysterectomy was associated with highest incidence of 2.5%,low anterior resections, 0.24% have been reported. 14,15 In our study Iatrogenic urinary lesions have an overall incidence of 1.6%, with a 34% of them with radical total hysterectomies, 8.5 % Werthiem's hysterectomy, 23.4% for colectomy, 25.5% in the case of anterior resection, 2.1% for radical prostatectomy and 6.4% retroperitoneal tumor excision.…”

Section: Discussionmentioning

confidence: 98%

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Ureteric injuries during cancer surgery presentation and management over a 20-year

et al. 2021

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Background: Iatrogenic ureteral injury rare 0.3-1.5%. complication of abdominopelvic cancer surgery. We aimed to study the risk and management of ureteral injury among cancer patients. Methods: Diagnosis can be achieved retrograde pyelography, ureteroscopy, CT, or intravenous urography. Results: Years 2000 to 2020, 2904 patients in the Department of Surgical oncology, Assuit University, and 47 ureteral injury cases were identified. (1.62), 4/231 cervical cancer, 9/611 ovarian cancer and 7/462 endometrial cancer.,11/818 colon cancer,12/620 rectal cancer, 1/11 prostatic cancer, 3/151 retroperitoneal sarcoma. 34% (radical abdominal hysterectomy 8.5% Wertheim hysterectomies 4%), colorectal surgery colectomy 25.5%, low anterior resection2.1% in radical prostatectomy and 6.4% in retroperitoneal tumor, intraoperative diagnosis 48.9%, 8.5% in laparoscopic surgeries, the distal third (53.2%),23.4% catheterization, complete transection 31.9%; partial 14.9%, ligation 8.5%, laceration in 19.1%, resection. 8.5%; and devascularization in 17%. Fever in 14.9%, abdominal or flank pain in 38.5%. Oligura in 6.4%, ileus in 19.3%, urinary leakage (vaginally or via abdominal wound) in 10.6% rise creatinine in 10.6%, hydronephrosis in 6.4%, urinoma in 27.7%, extravasation in 8.5% asymptomatic in 4.3%, 40.4% percutaneous nephrostomy. 19.1%primary repair Ureteroneocystostomy in (17%) Boari flap in 12.7%, Psoas hitch in 23.4% stenting in 14.9%, 8.5% ileum interposition, anastomosis to contralateral ureter in 4.3%, ureteral stricture 6.4%, ureterovaginal fistulas in 10.6%, acute renal failure 2.1%, peritonitis 4.3, urinary tract infection in 14.9%.Conclusions: The recognition and immediate repair of ureteral injuries early during the same procedure was highly desirable and to avoid a second operation.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 98%

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Ureteric injuries during cancer surgery presentation and management over a 20-year

et al. 2021

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“…Urologic injuries can be prevented by thoroughly identifying the ureter and careful surgical technique avoiding excessive devascularization of the ureter and excessive use of the cautery. The use of prophylactic stents in conventional laparoscopy and laparotomy has not shown to be cost effective for the prevention of urologic injury and has not been studied in robotic-assisted gynecologic surgery [77,78]. Bowel and vascular injuries have a low incidence and similar causes than conventional laparoscopic surgery.…”

Section: Surgical Complicationsmentioning

confidence: 99%

Robotic Hysterectomy for Cancer and Benign Pathology

Kohut¹,

Goldberg²,

Meritens³

2018

New Horizons in Laparoscopic Surgery

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The da Vinci Surgical System is an innovative technology that has advanced the laparoscopic treatment of benign and malignant diseases in gynecology. In this chapter, we will discuss the da Vinci Surgical System technology, including its history, utilization, surgical technique for benign and oncologic hysterectomy, future directions and surgical complications. Through a review of the literature, we aim to chronicle the current trends of application in both benign and oncologic gynecologic conditions and describe the current standards of care in this innovative and evolving operative technology. Although the future utility of robotic surgeries and robotic hysterectomies necessitates further research, the potential application of this surgical method affords great promise.

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“…There are a few reports on the efficacy of ureteral stent placement (USP) in total hysterectomy and laparoscopic surgery for benign diseases 1,4 . However, there are only a few reports on the efficacy of USP in cases of malignant tumors, and the few available reports are centered on only one type of gynecological cancer or include a small number of cases 5 . To our knowledge, there are no reports on the efficacy of USP in several gynecological cancers, including cervical, uterine, and ovarian cancers.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the efficacy and safety of ureteral stent placement as a preoperative procedure for gynecological cancer surgeries: A retrospective cohort study

Okawa

Komatsu

Iida

et al. 2021

J of Obstet and Gynaecol

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Aim To evaluate the efficacy and safety of ureteral stent placement (USP) as a preoperative procedure for gynecological cancer surgeries. Methods This was a single‐institution retrospective cohort study of 259 patients with gynecological cancer who underwent laparotomy. In 126 patients (USP+ group), a ureteral stent was inserted into the bilateral ureters after the induction of general anesthesia. The remaining 133 patients (USP− group) did not undergo USP. We compared operation time, blood loss, and frequency of laparotomy‐related perioperative urinary complications between the groups. The stent was removed 5–7 days postoperatively. Patients were evaluated for signs of hydronephrosis at discharge. The Fisher's exact test was used to investigate the significance of differences in patient characteristics, and multivariate analysis was performed using a Cox proportional hazards model. A p‐value of <0.05 was considered statistically significant. Results There were no significant differences in age and body mass index between the groups. Two patients in the USP− group experienced intraoperative ureteral injury. Total operation time and blood loss were significantly increased in the USP+ group. The risk of bladder tamponade and postoperative hydronephrosis was influenced by USP. USP was unaffected by a history of abdominal surgery, stage of tumor progression, lymphadenectomy type, or hysterectomy type. Conclusions The incidence of bladder tamponade and hydronephrosis postoperatively was significantly higher in patients with USP than in those without USP.

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Prophylactic pre-operative bilateral ureteric catheters for major gynaecological surgery

Abstract: Prophylactic pre-operative ureteric catheters are quick and easy to insert and associated with low complication rates. Routine use before major gynaecological surgery can expedite intra-operative identification of the ureters and may reduce accidental ureteric injury.

Cited by 26 publications

References 23 publications

Ureteric injuries during cancer surgery presentation and management over a 20-year

Ureteric injuries during cancer surgery presentation and management over a 20-year

Robotic Hysterectomy for Cancer and Benign Pathology

Evaluating the efficacy and safety of ureteral stent placement as a preoperative procedure for gynecological cancer surgeries: A retrospective cohort study

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