ISSN 2149-3235 | E-ISSN 2149-3057
GENERAL UROLOGY - Original Article
Routine prophylactic ureteral stenting before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Safety and usefulness from a single-center experience
1 Department of General and Emergency Surgery, Bufalini Hospital, Cesena, Italy  
2 Department of General and Emergency Surgery, ASST Papa Giovanni XXIII, Bergamo, Italy  
Turk J Urol 2019; 45: 372-376
DOI: 10.5152/tud.2019.19025
Key Words: Cytoreductive surgery; HIPEC; hydronephrosis; peritoneal carcinomatosis; prophylactic ureteral stenting.
Abstract

 

Objective: There are very few evidences about safety and usefulness of routine prophylactic ureteral stenting (PUS) before cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC).

 

Material and methods: An analysis of prospectively collected data about patients who underwent CRS and HIPEC for different sites of primary disease was carried out focusing on ureteral complications.

 

Results: A total of 138 patients who underwent CRS and HIPEC between December 2010 and June 2017 were considered. All patients underwent PUS before CRS and HIPEC. Of them, 91 (66.4%) patients received pelvic peritonectomy, 49 (35.8%) pelvic lymphadenectomy, 31 (22.6%) left hemicolectomy, 44 (32.4%) right hemicolectomy, 46 (33.6%) rectal resection, 56 (40.9%) hysteroannessiectomy, and 39 (28.5%) appendectomy. There was one (0.7%) postoperative ureteral fistula. The cumulative risk of ureteral stent-related major complications was 4.3% (two patients (1.4%) had protracted gross hematuria, two patients (1.4%) had urinary sepsis, and three patients (2.9%) developed hydronephrosis after a period from removing ureteral stents and required restenting. Morbidity due to ureteral stenting was associated with a longer length of stay (LOS) (p=0.053). A total of 52 patients (44.1%) developed renal dysfunction according to the RIFLE (Risk, Injury, Failure, Loss of kidney function, End-stage kidney-disease) criteria: 19.5% were in risk class, 10.2% in acute renal injury class, and 14.4% in acute renal failure class.

 

Conclusion: PUS could be a useful tool for reducing iatrogenic ureteral injury, but it is associated with a non-negligible morbidity, which implies longer LOS. A more accurate patient selection for PUS is necessary.

 

Cite this article as: Fugazzola P, Coccolini F, Tomasoni M, Cicuttin E, Sibilla MG, Gubbiotti F, et al. Routine prophylactic ureteral stenting before cytoreductive surgery and hyperthermic intraperitoneal chemotherapy: Safety and usefulness from a single-center experience. Turk J Urol 2019; 45(5): 372-6.

Key Words
Authors
All
Survey
AVES | Copyright © 2019 Turkish Association of Urology | Latest Update: 16.09.2019