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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
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Ureteral complications during colorectal surgery.

Kamir Ould Ahmed1, Marvin Jourdan2, Michael Baboudjian2

  • 1Urology Department, La Conception Hospital, Marseille, France.

Journal of Visceral Surgery
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Ureteral injuries during colorectal surgery are rare but serious. Early diagnosis and appropriate repair, including uretero-vesical re-implantation, minimize complications like leakage and strictures.

Keywords:
Double-J stentLich-Gregoir techniqueMonti ileal plastyPsoas-bladder hitch procedureUreteral complication

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Area of Science:

  • Urology
  • Colorectal Surgery
  • Surgical Complications

Background:

  • Ureteral complications following colorectal surgery are infrequent (0.3-1.5%) but lead to significant morbidity.
  • Diagnosis is often delayed, occurring postoperatively in 50-70% of cases.

Purpose of the Study:

  • To provide an updated overview of prevention, diagnosis, and treatment strategies for ureteral injuries in colorectal surgery.
  • To highlight current best practices for managing these rare but impactful complications.

Main Methods:

  • Review of current literature on ureteral injury prevention, intraoperative detection, and postoperative management.
  • Discussion of surgical techniques for ureteral repair, including direct anastomosis and re-implantation procedures.

Main Results:

  • Prevention involves identifying high-risk patients; routine prophylactic stenting is not advised.
  • Intraoperative localization techniques include methylene blue or indocyanine green injection.
  • Postoperative management varies from stenting to nephrostomy, with secondary repair based on injury characteristics.

Conclusions:

  • Prompt diagnosis and tailored surgical repair are crucial for optimal outcomes.
  • Uretero-vesical re-implantation may offer lower rates of anastomotic leakage compared to direct ureteral anastomosis.
  • Minimizing complications requires a thorough understanding of surgical anatomy and repair techniques.