Iatrogenic ureteral injury during retroperitoneal laparoscopy for large renal cysts: What we learned and a review of the literature

Zhang, Zejian1; Chen, Dong1; Deng, Ling1; Li, Wei1; Wang, Xisheng1; Zhang, Yixiang2; Liekui, Fang3; Feloney, Michael P.4; Zhang, Yuanyuan5

2021

10.3233/XST-200804

Journal of X-Ray Science and Technology   影响因子和分区

0895-3996

1095-9114

["PURPOSE: To avoid Iatrogenic ureteral injury during retroperitoneal laparoscopy for large renal cyst (diameter > 70 mm), we present two cases of iatrogenic ureteral injury and discuss their clinical courses and final outcomes.","PATIENTS AND METHODS: Two male patients (47 years old and 74 years old) with large left simple renal cysts underwent a retroperitoneal laparoscopic operation to treat the cysts. In the first patient, the left proximal ureter was partially transected (Grade 3) during the operation. The injury was identified intraoperatively. The transection was managed with a primary ureteroureterostomy (end to end) along with a double J ureteral stent. In the second patient, the left proximalureter was partially transected (Grade 4). However, the injury was unrecognized postoperatively for two days. After recognition of the complication, the injury was managed with an early primary ureteroureterostomy, which followed a failed attempt to place ureteral stent endoscopically.","RESULTS: In the first patient, a postoperative urinary leakage developed and lasted for 13 days. During long term follow-up of the first patient after the urine leak resolved, there were no reports of pain in the lumbar region or other discomfort. No recurrence of the renal cyst occurred, which was confirmed with an ultrasound at one year postoperatively. In the second patient a ureteral fistula and severe perirenal infection occurred and lasted for 86 days. The patient ultimately underwent a left nephrectomy after conservative management for this surgical complication failed. This patient developed a chronic wound infection that lasted for 3.14 months following the nephrectomy. During follow-up post nephrectomy, the patient developed stage 3B moderate chronic kidney disease (CKD) (GFR = 30 -44 ml/min).","CONCLUSIONS: For single large (diameter > 70 mm) renal cysts located at the lower pole of the kidney, it is recommended to not completely dissect out and mobilize the entire renal cyst for cyst decortication in order to avoid injuring the ureter. Iatrogenic ureteral injury increases the risk of readmission and serious life-threatening complications. The immediate diagnosis and proper management ureteric injury can reduce complications and long term sequalae."]

Renal cyst iatrogenic ureteral injury laparoscopic renal cyst decortication

SCI ; EI

英语

其他

Shenzhen Foundation of Science and Technology[JCYJ20170307094908637]

Instruments & Instrumentation ; Optics ; Physics

Instruments & Instrumentation ; Optics ; Physics, Applied

WOS:000623022500012

IOS PRESS

Web of Science

1.Guangdong Med Univ, Shenzhen Longhua Dist Cent Hosp, Affiliated Cent Hosp Shenzhen Longhua Dist, Dept Urol, Shenzhen, Guangdong, Peoples R China
2.Southern Univ Sci & Technol, Jinan Univ, Shenzhen Peoples Hosp, Dept Urol,Affiliated Hosp 1,Clin Med Coll 2, Shenzhen, Guangdong, Peoples R China
3.Southern Univ Sci & Techno, Shenzhen Peoples Hosp 3, Dept Urol, Affiliated Hosp 2, Shenzhen, Guangdong, Peoples R China
4.Creighton Univ, Sch Med, Dept Urol, Omaha, NE USA
5.Wake Forest Univ, Bowman Gray Sch Med, Wake Forest Inst Regenerat Med, Winston Salem, NC 27101 USA

Zhang, Zejian,Chen, Dong,Deng, Ling,et al. Iatrogenic ureteral injury during retroperitoneal laparoscopy for large renal cysts: What we learned and a review of the literature[J]. Journal of X-Ray Science and Technology,2021,29(1).

Zhang, Zejian.,Chen, Dong.,Deng, Ling.,Li, Wei.,Wang, Xisheng.,...&Zhang, Yuanyuan.(2021).Iatrogenic ureteral injury during retroperitoneal laparoscopy for large renal cysts: What we learned and a review of the literature.Journal of X-Ray Science and Technology,29(1).

Zhang, Zejian,et al."Iatrogenic ureteral injury during retroperitoneal laparoscopy for large renal cysts: What we learned and a review of the literature".Journal of X-Ray Science and Technology 29.1(2021).