Prophylactic Ureteral Stenting in Laparoscopic Colectomy: Revisiting Traditional Practice

Luks, Valerie L.; Merola, Jonathan; Arnold, Brian N.; Ibarra, Christopher; Pei, Kevin Y.

doi:10.1016/j.jss.2018.09.041

Cited by 19 publications

(26 citation statements)

References 17 publications

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“…Overall, 66 articles underwent full‐text review (Appendix ). We identified nine retrospective cohort studies suitable for inclusion published between 1994 and 2019 and evaluating 98 507 patients (Table 2) [2,4,5,13‐18]. No randomized controlled trials were identified.…”

Section: Resultsmentioning

confidence: 99%

“…Most studies evaluated patients undergoing laparoscopic colon resection [2,5,15,16,18]. One study included only patients undergoing open colectomy [13].…”

Section: Resultsmentioning

confidence: 99%

“…Most patients underwent surgery for malignancy or diverticular disease. Evaluation of the impact of ureteric stenting on the incidence of intraoperative ureteric injury was the primary outcome of four studies [2,4,13,17], whereas two studies sought to evaluate the safety of ureteric stent insertion [14,16] and one aimed to determine predictors of ureteric stent use [5] (Table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Ureteric injury is an uncommon, but serious, complication that can occur during pelvic surgery [1,2]. The incidence of intraoperative ureteric injury depends on the nature and complexity of the procedure, but can range from 0.2% to 7.6% [1,2]. Colon and rectal procedures are responsible for approximately 9% of all ureteral injuries [3].…”

Section: Introductionmentioning

confidence: 99%

“…Ureteric stenting may be particularly helpful during laparoscopic surgery when tactile identification of the ureter is not possible [5]. However, placement of ureteric catheters can be associated with prolonged operating time and increased cost [2]. In addition, adverse events have been reported, including acute kidney injury (AKI), urinary tract infection (UTI) and sepsis [6].…”

Section: Introductionmentioning

confidence: 99%

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Does prophylactic ureteric stenting at the time of colorectal surgery reduce the risk of ureteric injury? A systematic review and meta‐analysis

et al. 2021

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Aim Cystoscopic placement of ureteric stents during colorectal surgery (CRS) may aid in the intraoperative identification of the ureters and thus prevent ureteric injury, but may also be associated with prolonged operating time, increased cost and adverse events. No formal recommendations exist regarding the use of ureteric stents prior to CRS. Our aim was to determine the effect of prophylactic ureteric stent insertion on the risk of ureteric injury among adult patients undergoing CRS. Method A systematic search using the Ovid platform was completed. The primary outcome was risk of ureteric injury. Secondary outcomes included the risk of acute kidney injury (AKI), urinary tract infection (UTI), sepsis, length of stay (LOS) and mortality. The Paule–Mandel pooling and a random effects model was used to produce odds ratios (ORs) with 95% confidence intervals (CIs) for binary outcomes. Standardized mean differences (MD) were reported for continuous variables. Analyses were completed using R3.5. Results Nine retrospective cohort studies evaluating 98 507 patients were included. The incidence of ureteric injury was 0.6%. Overall, 5.1% of patients underwent ureteric stenting. There was no change in the odds of ureteric injury among stented patients compared with controls (OR 1.30, 95% CI 0.39‐4.29, I2 = 25%). Operating time was significantly longer (MD 49.3 min, 95% CI 35.3–63.4, I2 = 96%) in the intervention group. There was no difference in rates of AKI, UTI, sepsis, LOS or mortality between groups. Conclusion Given the retrospective nature of the identified studies, the benefit of prophylactic ureteric stenting remains uncertain. Prophylactic ureteric stenting was not associated with increased patient morbidity but did significantly increase operating time.

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Section: Resultsmentioning

confidence: 99%

“…Most studies evaluated patients undergoing laparoscopic colon resection [2,5,15,16,18]. One study included only patients undergoing open colectomy [13].…”

Section: Resultsmentioning

confidence: 99%