1 Sep 2016Systematic Review
Iatrogenic ureteral injury during laparoscopic colectomy: incidence and prevention. A current literature review
Giovanni Liguori 1Chiara Dobrinja 2Nicola Pavan 1Nicolò Manzini 2Stefano Bucci 1Silvia Palmisano 2Carlo Trombetta 1
Affiliations
Article Info
1 Department of Urology, University of Trieste, Cattinara Hospital, Trieste, Italy
2 Division of General Surgery, Department of Medical and Surgical Sciences, University of Trieste, Cattinara Hospital, Trieste, Italy
Ann. Ital. Chir., 2016, 87(5), 446-455;
Published: 1 Sep 2016
Copyright © 2016 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
INTRODUCTION: Iatrogenic ureteral injury (IUI) is a serious complication that can occur during abdominal or pelvic operations with a reported frequency in literature of approximately 0.3-1.5%. Moreover, the number of iatrogenic ureteric injuries has increased markedly during the past two decades, partly because of the introduction of laparoscopy and the overall increase in surgical procedures. MATERIAL AND METHOD: The present systematic review was set up to compare the incidence of IUI between laparoscopic and open colectomies. The study also assessed the features of the ureteric injuries and their prevention and management. We conducted a search of the literature for prospective and randomized clinical trials presenting a comparison between laparoscopic and open colorectal resections performed for any indication starting from 2003 to 2015. RESULTS: After an initial moderate increase in incidence of IUIs, with growing experience in laparoscopic surgery, ureteral injuries not seem to be more in laparoscopic surgery than conventional surgery. Many surgeons and gynecologists agree that prophylactic ureteral catheterization may reduce the chance of IUIs. CONCLUSIONS: Ureteral injury is especially difficult to detect during laparoscopic operations, and the symptoms of ureteric injury may develop either acutely or more insidiously, depending on the mechanism of injury. These injuries, if recognized late, can result in significant morbidity with loss of renal function. Early recognition and immediate repair of ureteral injuries during the same procedure is highly desirable. A ureteral injury not recognized and treated during the same procedure may require a temporary diverting nephrostomy and secondary surgery with increased morbidity.
Keywords
- Colectomy
- Injury
- Laparoscopy
- Ureter