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Erschienen in: International Journal of Colorectal Disease 6/2007

01.06.2007 | Original Article

A randomized controlled trial comparing simultaneous intra-operative vs sequential prophylactic ureteric catheter insertion in re-operative and complicated colorectal surgery

verfasst von: Naveen Pokala, Conor P. Delaney, Ravi P. Kiran, Jane Bast, Kenneth Angermeier, Victor W. Fazio

Erschienen in: International Journal of Colorectal Disease | Ausgabe 6/2007

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Abstract

Objectives

Prophylactic insertion of ureteric stents aids intra-operative identification of ureters and may allow easier visualization of any direct ureteric injury. Traditionally, ureteric catheters are inserted sequentially, before starting the abdominal part of the operation. This study determines the safety and efficacy of simultaneous intra-operative ureteric catheter insertion during complicated and re-operative colorectal surgery.

Materials and methods

After institutional review board (IRB) approval, 24 patients were randomized into two groups, sequential (SEQ) and simultaneous (SIM) depending upon the timing of stent placement relative to abdominal incision. Time taken from induction to abdominal incision (AIT), induction to peritoneal entry (PET), catheter insertion time (CIT), and urinary tract infection rates were recorded. Degree of difficulty for stent insertion was graded on a scale of 1–10.

Result

Demographics were similar between groups. Mean AIT (22 ± 4 vs 41 ± 7; p = 0.0001) and mean PET (26 ± 4.2 vs 44 ± 7.6; p = 0.0001) were shorter in the SIM group. There was no significant difference in mean CIT in SIM and SEQ groups (17.9 ± 4.9 vs 17.6 ± 5.9 min, p = 0.8). The stents were unsuccessful bilaterally in one patient in the SEQ group and unilaterally in two other patients, one in each group. The median difficulty score for catheter insertion was 3 (1–10) and 2 (1–10), (p = 0.12), respectively, in SIM and SEQ groups. There were no ureteric injuries in either group. One patient in SIM developed a urinary tract infection.

Conclusion

Simultaneous ureteric catheter insertion during abdominal procedures reduces operating times without a significant increase in morbidity. Furthermore, this permits a policy of selective stent insertion as required by the intra-abdominal findings after laparotomy.
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Metadaten
Titel
A randomized controlled trial comparing simultaneous intra-operative vs sequential prophylactic ureteric catheter insertion in re-operative and complicated colorectal surgery
verfasst von
Naveen Pokala
Conor P. Delaney
Ravi P. Kiran
Jane Bast
Kenneth Angermeier
Victor W. Fazio
Publikationsdatum
01.06.2007
Verlag
Springer-Verlag
Erschienen in
International Journal of Colorectal Disease / Ausgabe 6/2007
Print ISSN: 0179-1958
Elektronische ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-006-0219-1

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