OBJECTIVE: To investigate the outcome of laparoscopic repair of ureteral injury in laparoscopic gynecologic surgery. DESIGN: Prospective trial. SETTING:University hospital. PATIENT(S): Forty patients with a ureteral lesion in laparoscopic surgery between 1991 and 2007. INTERVENTION(S): Laparoscopic ureteral repair, laparoscopic-assisted or blind stent insertion. MAIN OUTCOME MEASURE(S): Treatment outcome of ureteral lesion analyzed by type of injury, time of diagnosis, and management. RESULT(S): In 4,350 consecutive laparoscopic gynecologic interventions, 42 lesions occurred, 5 during hysterectomy, 1 during adnexectomy, and 36 during deep endometriosis surgery. In the latter group (n = 1,427), the incidence was 1.5% and 21% in women without and with hydronephrosis, respectively. In eight women in whom a stent was inserted after surgery without laparoscopic guidance, five were uneventful and three needed a second intervention. In all 34 women in whom a laparoscopic repair over a stent was performed, the outcome was uneventful, whether diagnosed and treated during surgery (n = 25) or after surgery (n = 9). CONCLUSION(S): Laparoscopic repair over a stent was uneventful for all lacerations, transections, and fistulas, whether performed during or after surgery, and was superior to blind stent insertion. In women with hydronephrosis and deep endometriosis, a preoperative stent insertion seems to be mandatory.
RCT Entities:
OBJECTIVE: To investigate the outcome of laparoscopic repair of ureteral injury in laparoscopic gynecologic surgery. DESIGN: Prospective trial. SETTING: University hospital. PATIENT(S): Forty patients with a ureteral lesion in laparoscopic surgery between 1991 and 2007. INTERVENTION(S): Laparoscopic ureteral repair, laparoscopic-assisted or blind stent insertion. MAIN OUTCOME MEASURE(S): Treatment outcome of ureteral lesion analyzed by type of injury, time of diagnosis, and management. RESULT(S): In 4,350 consecutive laparoscopic gynecologic interventions, 42 lesions occurred, 5 during hysterectomy, 1 during adnexectomy, and 36 during deep endometriosis surgery. In the latter group (n = 1,427), the incidence was 1.5% and 21% in women without and with hydronephrosis, respectively. In eight women in whom a stent was inserted after surgery without laparoscopic guidance, five were uneventful and three needed a second intervention. In all 34 women in whom a laparoscopic repair over a stent was performed, the outcome was uneventful, whether diagnosed and treated during surgery (n = 25) or after surgery (n = 9). CONCLUSION(S): Laparoscopic repair over a stent was uneventful for all lacerations, transections, and fistulas, whether performed during or after surgery, and was superior to blind stent insertion. In women with hydronephrosis and deep endometriosis, a preoperative stent insertion seems to be mandatory.
Authors: Allen F Morey; Steve Brandes; Daniel David Dugi; John H Armstrong; Benjamin N Breyer; Joshua A Broghammer; Bradley A Erickson; Jeff Holzbeierlein; Steven J Hudak; Jeffrey H Pruitt; James T Reston; Richard A Santucci; Thomas G Smith; Hunter Wessells Journal: J Urol Date: 2014-05-20 Impact factor: 7.450
Authors: Gil Kamergorodsky; Nucelio Lemos; Francisco C Rodrigues; Fernando Yassuo Asanuma; Paulo D'Amora; Eduardo Schor; Manoel J B C Girão Journal: Surg Endosc Date: 2014-11-08 Impact factor: 4.584
Authors: Alvaro Juarez-Soto; Jose Miguel Arroyo-Maestre; Manuel Soto-Delgado; Pastora Beardo-Villar; Miguel Angel Arrabal-Polo; Francisco Miguel Sánchez-Margallo Journal: Can Urol Assoc J Date: 2014-05 Impact factor: 1.862
Authors: Zongyao Hao; Li Zhang; Jun Zhou; Xiansheng Zhang; Haoqiang Shi; Yifei Zhang; Song Fan; Chaozhao Liang Journal: Int Sch Res Notices Date: 2014-11-09
Authors: Alfredo Aguilera; Juan Gomez Rivas; Luis M Quintana Franco; Jose Quesada-Olarte; Diego M Carrion; Luis Martínez-Piñeiro Journal: Cent European J Urol Date: 2019-08-20