Ohnuma Shinobu, Kanehara Keigo, Sato Yukihiro, Ono Tomoyuki, Murakami Megumi, Kajiwara Taiki, Suzuki Hideyuki, Karasawa Hideaki, Watanabe Kazuhiro, Kawamorita Naoki, Ito Akihiro, Kamei Takashi, Unno Michiaki
Department of Surgery, Tohoku University Graduate School of Medicine, Sendai 980-8574, Miyagi, Japan.
Department of Urology, Tohoku University Graduate School of Medicine, Sendai 980-8574, Miyagi, Japan.
J Clin Med. 2025 Jun 11;14(12):4123. doi: 10.3390/jcm14124123.
Iatrogenic ureteral injury is a rare but serious complication of colorectal cancer surgery. Although prophylactic ureteral catheterization (PUC) is used to facilitate intraoperative ureter identification and reduce the risk of ureteral injury, its efficacy is debated. We aimed to evaluate the clinical utility and outcomes of PUC in colorectal cancer surgery. : This retrospective study included 42 patients who underwent PUC before colorectal cancer surgery at the Tohoku University Hospital between February 2010 and September 2024. Preoperative ureteral stents were inserted via cystoscopy under general anesthesia. Patient demographics, surgical techniques, indications for catheterization, and post-procedural complications were reviewed. : PUC was most frequently performed in patients with left-sided colorectal cancer (61.9%) and local recurrence of rectal cancer (31%). Ureteral catheterization was indicated in patients with a history of pelvic surgery (47.6%) or tumor proximity to the ureter (26.2%). Open surgery was performed in 90.5% of the cases, whereas robotic surgery with fluorescent ureteral catheters was used in selected patients. No intraoperative ureteral injury was observed in the stent group. Catheter-related complications, including hematuria (14.3%) and urinary tract infections (9.5%), were minor and resolved before discharge. : PUC may be beneficial in patients with a history of pelvic surgery or local recurrence of rectal cancer, in whom the risk of ureteral injury is inherently higher.
医源性输尿管损伤是结直肠癌手术中一种罕见但严重的并发症。尽管预防性输尿管插管（PUC）用于便于术中识别输尿管并降低输尿管损伤风险，但其疗效仍存在争议。我们旨在评估PUC在结直肠癌手术中的临床效用和结果。：这项回顾性研究纳入了2010年2月至2024年9月在东北大学医院接受结直肠癌手术前进行PUC的42例患者。术前在全身麻醉下通过膀胱镜插入输尿管支架。回顾了患者的人口统计学资料、手术技术、插管指征和术后并发症。：PUC最常用于左侧结直肠癌患者（61.9%）和直肠癌局部复发患者（31%）。有盆腔手术史（47.6%）或肿瘤靠近输尿管（26.2%）的患者进行输尿管插管。90.5%的病例采用开放手术，而部分患者采用带有荧光输尿管导管的机器人手术。支架组未观察到术中输尿管损伤。导管相关并发症，包括血尿（14.3%）和尿路感染（9.5%），较轻微，出院前已缓解。：PUC可能对有盆腔手术史或直肠癌局部复发的患者有益，这些患者输尿管损伤风险本身较高。
