Comparative Study of Ureteral Injury After Laparoscopic or Laparotomy Rectal Surgery

Document Type : Research/Original Article

Authors

1 Colorectal research center, Shiraz University of medical sciences, Shiraz, Iran

2 Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran

3 Colorectal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

4 colorectal research center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Background Despite the low incidence rate, ureteral injuries can lead to significant morbidity. Urinary organs can be injured during open or laparoscopic surgery. This study aimed to assess whether a ureteral injury exists between laparoscopic and open surgery over 20 years in Shiraz.
Methods This is a retrospective study and 779 patients of rectal cancer were evaluated in Shiraz from 2000 to 2021 by collecting data from the patients’ electronic charts. We evaluated the type of surgery, gender, age, body mass index (BMI), stage, appearance and size of the tumor, preoperative (chemo)-radio-therapy, recurrence, and metastasis. Ureteral injury was analyzed and urinary incontinence was recorded.
Results A total number of 131 (22.2%) in laparoscopy surgeries and 42 (30.6%) in laparotomy surgeries had abdominoperineal (A-P) resection. The total number of 254 (43%) in laparoscopy surgeries and 61 (44.5%) of patients had low anterior resection in laparotomy surgeries. The incidence of ureteral injuries was 2.2% for open procedures and 1.5% for laparoscopic and 2.2% for conversion procedures. The rate of urinary incontinence was 65 (11.0%) in laparoscopy and 9 (6.6%) in laparotomy group.
Conclusion It is concluded that the ureteral injury after laparotomy is more than laparoscopic surgeries. Although the number of side effects of these surgeries is low, it can be concluded that the possibility of damage to the ureter is less in laparoscopic surgery and that of damage to the nerves of the pelvic floor is more.

Keywords

References

  1.  Jacobs M, Verdeja JC, Goldstein HS. Minimally invasive colon resection (laparoscopic colectomy). Surgical laparoscopy & endoscopy. 1991;1(3):144-50.
  2. Green BL, Marshall HC, Collinson F, Quirke P, Guillou P, Jayne DG, et al. Long-term follow-up of the Medical Research Council CLASICC trial of conventional versus laparoscopically assisted resection in colorectal cancer. The British journal of surgery. 2013;100(1):75-82.
  3. Ohtani H, Tamamori Y, Arimoto Y, Nishiguchi Y, Maeda K, Hirakawa K. A meta-analysis of the short- and long-term results of randomized controlled trials that compared laparoscopy-assisted and open colectomy for colon cancer. Journal of Cancer. 2012;3:49-57.
  4. Richardson MC, Bell G, Fullarton GM. Frequencyand nature of bile duct injuries following laparoscopic cholecystectomy: an audit of 5913 cases. West of Scotland Laparoscopic Cholecystectomy Audit Group. The British journal of surgery. 1996;83(10):1356-60.
  5. Nieboer TE, Johnson N, Lethaby A, Tavender E, Curr E, Garry R, et al. Surgical approach to hysterectomy for benign gynaecological disease. The Cochrane database of systematic reviews. 2009(3):Cd003677.
  6. Palaniappa NC, Telem DA, Ranasinghe NE, Divino CM. Frequencyof iatrogenic ureteral injury after laparoscopic colectomy. Archives of surgery (Chicago, Ill : 1960). 2012;147(3):267-71.
  7. Halabi WJ, Jafari MD, Nguyen VQ,Carmichael JC, Mills S, Pigazzi A, et al. Ureteral injuries in colorectal surgery: an analysis of trends, outcomes, and risk factors over a 10-year period in the United States. Diseases of the colon and rectum. 2014;57(2):179-86.
  8. Marcelissen TA, Den Hollander PP, Tuytten TR, Sosef MN. Frequencyof Iatrogenic Ureteral Injury During Open and Laparoscopic Colorectal Surgery: A Single Center Experience and Review of the Literature. Surgical laparoscopy, endoscopy & percutaneous techniques. 2016;26(6):513-5.
  9. Boyan WP, Jr., Lavy D, Dinallo A, Otero J, Roding A, Hanos D, et al. Lighted ureteral stents in laparoscopic colorectal surgery; a five-year experience. Annals of translational medicine. 2017;5(3):44.
  10. Speicher PJ, Goldsmith ZG, Nussbaum DP, Turley RS, Peterson AC, Mantyh CR. Ureteral stenting in laparoscopic colorectal surgery. The Journal of surgical research. 2014;190(1):98-103.
  11. Garg R, . Ureteric Injury in Gynecology Surgery. Urinary Tract Infection and Nephropathy - Insights into Potential Relationship 2021.
  12. Yellinek S, Krizzuk D, J JN, S DW. Ureteral Injury During Colorectal Surgery: Two Case Reports and a Literature Review. Journal of the anus, rectum and colon. 2018;2(3):71-6.
  13. Kim NK, Kim HS, Alessa M, Torky R. Optimal Complete Rectum Mobilization Focused on the Anatomy of the Pelvic Fascia and Autonomic Nerves: 30 Years of Experience at
    Severance Hospital. Yonsei medical journal. 2021;62(3):187-99.
  14. Zafar SN, Ahaghotu CA, Libuit L, Ortega G, Coleman PW, Cornwell EE, 3rd, et al. Ureteral injury after laparoscopic versus open colectomy. JSLS : Journal of the Society of Laparoendoscopic Surgeons. 2014;18(3).
  15. Nesargikar PN, Kaur V, Cocker DM, Lengyel J. Consenting for pelvic nerve injury in colorectal surgery: need to address age and gender bias. Annals of the Royal College of Surgeons of England. 2010;92(5):391-4.
  16. Jayne DG, Brown JM, Thorpe H, Walker J, Quirke P, Guillou PJ. Bladder and sexual function following resection for rectal cancer in a randomized clinical trial of laparoscopic versus open technique.        The British journal of surgery. 2005;92(9):1124-32.
  17. Chan DK, Chong CS, Lieske B, Tan KK. Laparoscopic resection for rectal cancer: what is the evidence? BioMed research international. 2014;2014:347810.
  18. Attaallah W, Ertekin SC, Yegen C. Prospective study of sexual dysfunction after proctectomy for rectal cancer. Asian journal of surgery. 2018;41(5):454-61.
Iranian Journal of Colorectal Research
Volume 10, Issue 3
September 2022
Pages 98-102

Files

Share

How to cite

Statistics