[Ureteral injuries in rectal surgery]

Injuries to the ureter were found to occur primarily in cases of left-side Dukes C tumour, along with dissection of regional lymph nodes to cope with peritumorous infiltration. The area of an injury must be very carefully dissected. A splint should be inserted, when the ureteral lumen has been opened. A few approximation sutures should be made and the retroperitoneum drained. Anti-refluxive re-implantation and Psoas Hitch plasty are recommended to cope with situations in which distal parts of the ureter are missing (due to direct or indirect damage or late sequels). Percutaneous nephrostomy is considered to be the optional therapeutic approach to extravasation and engorgement of the kidney.