WHICH PATIENTS REQUIRE PROPHYLACTIC URETERAL CATHETERIZATION TO PREVENT URETERAL INJURY IN COLORECTAL CANCER SURGERY? sohnuma@tohoku.ac.jp

PW02-12

WHICH PATIENTS REQUIRE PROPHYLACTIC URETERAL CATHETERIZATION TO PREVENT URETERAL INJURY IN COLORECTAL CANCER SURGERY?

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Masamichi Mizuma masamichi.mizuma.e5@tohoku.ac.jp Tohoku University Hospital Department of Surgey Sendai Japan

Takashi Kamei takashi.kamei.a8@tohoku.ac.jp Tohoku University Hospital Department of Surgey Sendai Japan

Michiaki Unno michiaki.unno.e5@tohoku.ac.jp Tohoku University Hospital Department of Surgey Sendai Japan

Japan

Oral or Poster

Iatrogenic ureteral injury is a rare but serious complication of colorectal cancer surgery. Although prophylactic ureteral catheterization (PUC) is used to facilitate intraoperative ureter identification and reduce the risk of ureteral injury, its efficacy is debated. We aimed to evaluate the clinical utility and outcomes of PUC in colorectal cancer surgery.

This retrospective study included 42 patients who underwent PUC before colorectal cancer surgery at the Tohoku University Hospital between February 2010 and September 2024. Preoperative ureteral stents were inserted via cystoscopy under general anesthesia. Patient demographics, surgical techniques, indications for catheterization, and post-procedural complications were reviewed.

During the study period, 1411 CRC resections were performed, resulting in a ureteral stent insertion rate was 3.0% (42/1411). Among the patients with PUC, open surgery was performed in 90.5% of the cases, whereas robotic surgery with fluorescent ureteral catheters was used in selected patients. Ureteral catheterization was indicated in patients with a history of pelvic surgery (47.6%) or tumor proximity to the ureter (26.2%), including bulky left-sided colorectal cancer and local recurrence of rectal cancer. No intraoperative ureteral injury was observed in the stent group. Catheter-related complications, including hematuria (14.3%) and urinary tract infections (9.5%), were minor and resolved before discharge.

PUC may be beneficial in patients in whom ureteral identification is challenging, such as those with a history of pelvic surgery and local recurrence of rectal cancer.