Evaluating the efficacy and safety of ureteral stent placement as a preoperative procedure for gynecological cancer surgeries: A retrospective cohort study.
bladder tamponade
gynecologic cancer
hydronephrosis
laparotomy
ureteral stent
Journal
The journal of obstetrics and gynaecology research
ISSN: 1447-0756
Titre abrégé: J Obstet Gynaecol Res
Pays: Australia
ID NLM: 9612761
Informations de publication
Date de publication:
Aug 2021
Aug 2021
Historique:
revised:
16
04
2021
received:
29
12
2020
accepted:
03
05
2021
pubmed:
12
5
2021
medline:
6
8
2021
entrez:
11
5
2021
Statut:
ppublish
Résumé
To evaluate the efficacy and safety of ureteral stent placement (USP) as a preoperative procedure for gynecological cancer surgeries. 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. 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. The incidence of bladder tamponade and hydronephrosis postoperatively was significantly higher in patients with USP than in those without USP.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
2752-2757Informations de copyright
© 2021 Japan Society of Obstetrics and Gynecology.
Références
Schimpf MO, Gottenger EE, Wagner JR. Universal ureteral stent placement at hysterectomy to identify ureteral injury: a decision analysis. BJOG. 2008;115:1151-8.
Bretschneider CE, Casas-Puig V, Sheyn D, et al. Delayed recognition of lower urinary tract injuries following hysterectomy for benign indications: a NSQIP-based study. Am J Obstet Gynecol. 2019;221:132.e1-132.e13.
Likic IS, Kadija S, Ladjevic NG, et al. Analysis of urologic complications after radical hysterectomy. Am J Obstet Gynecol. 2008;199:644.e1-3.
Tanaka Y, Asada H, Kuji N, et al. Ureteral catheter placement for prevention of ureteral injury during laparoscopic hysterectomy. J Obstet Gynaecol Res. 2008;34:67-72.
Merritt AJ, Crosbie EJ, Charova J, et al. Prophylactic pre-operative bilateral ureteric catheters for major gynaecological surgery. Arch Gynecol Obstet. 2013;288:1061-6.
Abu-Zaid A, Abou Al-Shaar H, Azzam A, et al. Routine ureteric stenting before cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy in managing peritoneal carcinomatosis from gynecologic malignancies: a single-center experience. Ir J Med Sci. 2017;186:269-73.
Speicher PJ, Goldsmith ZG, Nussbaum DP, et al. Ureteral stenting in laparoscopic colorectal surgery. J Surg Res. 2014;190:98-103.
Luks VL, Merola J, Arnold BN, et al. Prophylactic ureteral stenting in laparoscopic colectomy: revisiting traditional practice. J Surg Res. 2019;234:161-6.
Tschada R, Mickisch G, Rassweiler J, et al. Success and failure with double J ureteral stent. Analysis of 107 cases. J Urol (Paris). 1991;97:93-7.
Ramsay JW, Payne SR, Gosling PT, et al. The effects of double J stenting on unobstructed ureters. An experimental and clinical study. Br J Urol. 1985;57:630-4.
Hekimoğlu B, Men S, Pinar A, et al. Urothelial hyperplasia complicating use of metal stents in malignant ureteral obstruction. Eur Radiol. 1996;6:675-81.