Iatrogenic ureteral injury during colorectal surgery has a significant impact on patient outcomes: a French multicentric retrospective cohort study.
chemotherapy
colorectal surgery
ureteral injury
ureteral stent
Journal
Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland
ISSN: 1463-1318
Titre abrégé: Colorectal Dis
Pays: England
ID NLM: 100883611
Informations de publication
Date de publication:
07 2023
07 2023
Historique:
revised:
10
04
2023
received:
03
12
2022
accepted:
13
04
2023
medline:
24
7
2023
pubmed:
31
5
2023
entrez:
31
5
2023
Statut:
ppublish
Résumé
The long-term urological sequelae after iatrogenic ureteral injury (IUI) during colorectal surgery are not clearly known. The aims of this work were to report the incidence of IUI and to analyse the long-term consequences of urological late complications and their impact on oncological results of IUI occurring during colorectal surgery through a French multicentric experience (GRECCAR group). All the patients who presented with IUI during colorectal surgery between 2010 and 2019 were retrospectively included. Patients with ureteral involvement needing en bloc resection, delayed ureteral stricture or noncolorectal surgery were not considered. A total of 202 patients (93 men, mean age 63 ± 14 years) were identified in 29 centres, corresponding to 0.32% of colorectal surgeries (n = 63 562). Index colorectal surgery was mainly oncological (n = 130, 64%). IUI was diagnosed postoperatively in 112 patients (55%) after a mean delay of 11 ± 9 days. Intraoperative diagnosis of IUI was significantly associated with shorter length of stay (21 ± 22 days vs. 34 ± 22 days, p < 0.0001), lower rates of postoperative hydronephrosis (2% vs. 10%, p = 0.04), anastomotic complication (7% vs. 22.5%, p = 0.002) and thromboembolic event (0% vs. 6%, p = 0.02) than postoperative diagnosis of IUI. Delayed chemotherapy because of IUI was reported in 27% of patients. At the end of the follow-up [3 ± 2.6 years (1 month-13 years)], 72 patients presented with urological sequalae (36%). Six patients (3%) required a nephrectomy. IUI during colorectal surgery has few consequences for the patients if recognized early. Long-term urological sequelae can occur in a third of patients. IUI may affect oncological outcomes in colorectal surgery by delaying adjuvant chemotherapy, especially when the ureteral injury is not diagnosed peroperatively.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1433-1445Investigateurs
Sophie Chopinet
(S)
Christophe Taoum
(C)
Benoît Romain
(B)
Cecile Brigand
(C)
Denis Pezet
(D)
Guillaume Piessen
(G)
Hélène Rajaonarison
(H)
Johan Gagnière
(J)
Adel Omouri
(A)
Daniel Leonard
(D)
Christine Pirlet
(C)
Jean-Marc Regimbeau
(JM)
Christine Denet
(C)
Nicolas Goesguen
(N)
Jeremie Lefevre
(J)
Eloise Papet
(E)
Informations de copyright
© 2023 Association of Coloproctology of Great Britain and Ireland.
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