ArticleSurgical endoscopy2021
Ureteral injuries in colorectal surgery and the impact of laparoscopic and robotic-assisted approaches.
Article in Surgical endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it, 24 citations in OpenAlex.
- Preventing iatrogenic ureteral injury in colorectal surgery: a comprehensive and systematic review of the last 2 decades of literature and future perspectives.Surgery today · 2024Pooled it
- 2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery.World journal of emergency surgery : WJES · 2023Guideline
- [Iatrogenic ureteral injuries-medical and legal aspects].Urologie (Heidelberg, Germany) · 2026Review
- Water Under the Bridge: Ureteral Injury After Robotic Versus Laparoscopic Rectal Surgery.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Iatrogenic ureteral injury in colorectal surgery: a retrospective cohort analysis of risk factors and preventive strategies.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2026Article
- Can Surgical Approach and Postoperative Factors Impact Survival in Rectal Cancer? Robotic Versus Laparoscopic Insights.Cancer medicine · 2025Article
- Deep learning-based intraoperative visual guidance model for ureter identification in laparoscopic sigmoidectomy.Surgical endoscopy · 2025Article
- Case Report: Unusual presentation and atypical course of a case of ureterocolic fistula after anterior resection for sigmoid cancer.Frontiers in oncology · 2025Article
- Association of severe obesity with risk of conversion to open in laparoscopic cholecystectomy for acute cholecystitis.Surgery open science · 2024Article
- A case of one-stage laparoscopic drainage and ureterocystoneostomy for iatrogenic ureteral injury associated with infected urinoma.IJU case reports · 2023Article
- Effectiveness and Cost of Stenting in Ureteral Injury in Colorectal Surgeries in the US: 2015 - 2019.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
Corrections and comments
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUreteral injury is a feared complication in colorectal surgery that has been increasing over the past decade. Some have attributed this to an increased adoption of minimally invasive surgery (MIS), but the literature is hardly conclusive. In this study we aim to further assess the overall trend of ureteral injuries in colorectal surgery, and investigate propensity adjusted contributions from open and MIS to include robotic-assisted surgery.
methodsThis is a retrospective analysis of colorectal surgeries from 2006 to 2016 using the Nationwide Inpatient Sample (NIS) database. Multivariable logistic regression was performed to identify predisposing and protective factors. Demographics, hospital factors, and case-mix differences for open and MIS were accounted for via propensity analysis. The NIS coding structure changed in 2015, which could introduce a potential source of incongruity in complication rates over time. As a result, all statistical analyses included only the first nine years of data, or were conducted before and after the change for comparison.
resultsOf 514,162 colorectal surgeries identified there were 1598 ureteral injuries (0.31%). Ureteral injuries were found to be increasing through 2015 (2.3/1000 vs 3.3/1000; p < 0.001) and through the coding transition to 2016 (4.8/1000; p < 0.001). This trend was entirely accounted for by injuries made during open surgery, with decreasing injury rates for MIS over time. Adjusted odds ratio (OR) for ureteral injury with all MIS vs. open cases was 0.81 (95% CI 0.70-0.93, p = 0.003) and for robotic-assisted surgery alone versus open cases was 0.50 (95% CI 0.33-0.77, p = 0.001).
conclusionsThe incidence rate of ureteral injuries during open colorectal surgery is increasing over time, but have been stable or decreasing for MIS cases. These findings hold even after using propensity score analysis. More research is needed to further delineate the impact of MIS and robotic-assisted surgery on ureteral injuries.
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