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News

Risk factors for ureteral injuries in colorectal surgery

The latest issue of the Diseases of the Colon & Rectum evaluates trends, outcomes, and risk factors for uretal injuries in colorectal surgery in the USA.

News image

Iatrogenic ureteral injuries during colorectal surgical procedures are rare. Little is known about their incidence, associated outcomes, and predisposing factors.

Dr Wissam Halabi and colleagues examined the trends of iatrogenic ureteral injuries in the United States over a decade, as well as their outcomes and risk factors.

The research team performed a retrospective study analyzing a nationwide inpatient sample from 2001 to 2010.

Included were patients with colorectal cancer, benign polyps, diverticular disease, or inflammatory bowel disease undergoing colorectal surgery.

The research team examined trends of iatrogenic ureteral injuries occurring in colon and rectal surgical procedures over a 10-year period.

Ureteral injuries were independently associated with higher hospital charges by $31,497
Diseases of the Colon & Rectum

Mortality, morbidity, length of stay and total charge associated with ureteral injuries were analyzed on multivariate analysis.

Finally, a predictive model for ureteral injuries was built using patient, hospital, and operative variables.

An estimated 2,165,848 colorectal surgical procedures were performed in the United States over the study period, and 6027 ureteral injuries were identified.

The team found that the rate of ureteral injuries was higher in the second half of the decade compared with the first half.

Ureteral injuries were independently associated with higher mortality, morbidity, longer length of stay, and higher hospital charges by $31,497.

The team found that risk factors for ureteral injuries included rectal cancer, adhesions, metastatic cancer, weight loss/malnutrition, and teaching hospitals.

Protective factors included the use of laparoscopy, transverse colectomy, and right colectomy.

Dr Halabi's team concludes, "Iatrogenic ureteral injuries are rare complications in colorectal surgery."

"However, their incidence appears to be rising. Ureteral injuries are associated with higher mortality, morbidity, hospital charge, and length of stay, and their incidence can be predicted by several factors."

Dis Colon Rectum 2014: 57(2): 179–186
07 February 2014

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