Okawa Masayo, Komatsu Hiroaki, Iida Yuki, Osaku Daiken, Sato Shinya, Oishi Tetsuro, Harada Tasuku
Department of Obstetrics and Gynecology, Tottori University School of Medicine, Yonago, Tottori Prefecture, Japan.
J Obstet Gynaecol Res. 2021 Aug;47(8):2752-2757. doi: 10.1111/jog.14829. Epub 2021 May 11.
To evaluate the efficacy and safety of ureteral stent placement (USP) as a preoperative procedure for gynecological cancer surgeries.
This was a single-institution retrospective cohort study of 259 patients with gynecological cancer who underwent laparotomy. In 126 patients (USP+ group), a ureteral stent was inserted into the bilateral ureters after the induction of general anesthesia. The remaining 133 patients (USP- group) did not undergo USP. We compared operation time, blood loss, and frequency of laparotomy-related perioperative urinary complications between the groups. The stent was removed 5-7 days postoperatively. Patients were evaluated for signs of hydronephrosis at discharge. The Fisher's exact test was used to investigate the significance of differences in patient characteristics, and multivariate analysis was performed using a Cox proportional hazards model. A p-value of <0.05 was considered statistically significant.
There were no significant differences in age and body mass index between the groups. Two patients in the USP- group experienced intraoperative ureteral injury. Total operation time and blood loss were significantly increased in the USP+ group. The risk of bladder tamponade and postoperative hydronephrosis was influenced by USP. USP was unaffected by a history of abdominal surgery, stage of tumor progression, lymphadenectomy type, or hysterectomy type.
The incidence of bladder tamponade and hydronephrosis postoperatively was significantly higher in patients with USP than in those without USP.
