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02-01-2023 | Acute Kidney Injury | Review Article

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

Authors: Pier Paolo Brollo, Alessandro Puggioni, Francesco Tumminelli, Antonio Colangelo, Carlo Biddau, Vittorio Cherchi, Vittorio Bresadola

Published in: Surgery Today | Issue 4/2024

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.

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Title: Preventing iatrogenic ureteral injury in colorectal surgery: a comprehensive and systematic review of the last 2 decades of literature and future perspectives
Authors: Pier Paolo Brollo
Alessandro Puggioni
Francesco Tumminelli
Antonio Colangelo
Carlo Biddau
Vittorio Cherchi
Vittorio Bresadola
Publication date: 02-01-2023
Publisher: Springer Nature Singapore
Keywords: Acute Kidney Injury
Ureteral Injury
Minimally Invasive Surgery
Acute Kidney Injury
Published in: Surgery Today / Issue 4/2024
Print ISSN: 0941-1291
Electronic ISSN: 1436-2813
DOI: https://doi.org/10.1007/s00595-022-02639-9

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

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