Iatrogenic ureteral injury during colorectal surgery has a significant impact on patient outcomes: a French multicentric retrospective cohort study - Centre Paul Strauss
Article Dans Une Revue Colorectal Disease Année : 2023

Iatrogenic ureteral injury during colorectal surgery has a significant impact on patient outcomes: a French multicentric retrospective cohort study

1 AMU SMPM MED - Aix-Marseille Université - École de médecine
2 TIMONE - Hôpital de la Timone [CHU - APHM]
3 CRLCC Val d'Aurelle - Paul Lamarque
4 IRFAC - Inserm U1113 - Interface de Recherche Fondamentale et Appliquée en Cancérologie
5 CHRU Lille - Centre Hospitalier Régional Universitaire [CHU Lille]
6 M2iSH - Microbes, Intestin, Inflammation et Susceptibilité de l'Hôte
7 TIMC - Translational Innovation in Medicine and Complexity / Recherche Translationnelle et Innovation en Médecine et Complexité - UMR 5525
8 CHUGA - Centre Hospitalier Universitaire [CHU Grenoble]
9 Hôpital Bicêtre [AP-HP, Le Kremlin-Bicêtre]
10 HEGP - Hôpital Européen Georges Pompidou [APHP]
11 Hôpital Beaujon [AP-HP]
12 Service de Chirurgie Viscérale et Digestive [CHU Caen]
13 ANTICIPE - Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers
14 UNICAEN Santé - Université de Caen Normandie - UFR Santé
15 Cliniques Universitaires Saint-Luc [Bruxelles]
16 HIFIH - Hémodynamique, Interaction Fibrose et Invasivité tumorales Hépatiques
17 CAP Paris-Tech (UMR_S_1275) - CArcinose Péritoine Paris-Technologies (ex-CART)
18 CHU Pitié-Salpêtrière [AP-HP]
19 Chirurgie digestive [CHU Amiens]
20 SSPC - Simplification des soins chez les patients complexes - UR UPJV 7518
21 IMM - Institut Mutualiste de Montsouris
22 Service d'Oncologie Médicale [CHRU Besançon]
23 LaTIM - Laboratoire de Traitement de l'Information Medicale
24 LIRIC - Lille Inflammation Research International Center - U 995
25 Hôpital Claude Huriez [Lille]
26 CAPTuR - Contrôle de l’Activation Cellulaire, Progression Tumorale et Résistance thérapeutique
27 Service de Chirurgie digestive, endocrinienne et générale [CHU Limoges]
28 Hôpital Nord [CHU - APHM]
29 UNICANCER/ICO - Institut de Cancérologie de l'Ouest [Angers/Nantes]
30 NGERE - Nutrition-Génétique et Exposition aux Risques Environnementaux
31 Service de Chirurgie Digestive Hépatobiliaire et Endocrine [CHRU Nancy]
32 Groupe Hospitalier Diaconesses Croix Saint-Simon
33 CHU Nantes - Centre Hospitalier Universitaire de Nantes = Nantes University Hospital
34 Hôpital Trousseau
35 MEPPOT - Médecine personnalisée, pharmacogénomique, optimisation, thérapeutique = Personalized MEdicine, Pharmacogenomics, Therapeutic OPtimization [CRC]
36 IGR - Institut Gustave Roussy
37 CHU Saint-Antoine [AP-HP]
38 Service de Chirurgie Digestive [CHU Rouen]
39 Chirurgie Générale et Digestive [Rangueil]
40 GRECCAR - The French Research Group of Rectal Cancer Surgery = Groupe de Recherche en Chirurgie du Rectum
Philippe Rouanet
Mehdi Ouaissi
  • Fonction : Auteur
Maxime Collard
Diane Mege

Résumé

Aim: 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). Method: 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. Results: 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. Conclusion: 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.

Domaines

Chirurgie
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Dates et versions

hal-04113776 , version 1 (22-05-2024)

Identifiants

Citer

Victor Sérénon, Philippe Rouanet, Diane Charleux-Muller, Clarisse Eveno, Karine Poirot, et al.. Iatrogenic ureteral injury during colorectal surgery has a significant impact on patient outcomes: a French multicentric retrospective cohort study. Colorectal Disease, 2023, 25 (7), pp.1433-1445. ⟨10.1111/codi.16630⟩. ⟨hal-04113776⟩
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