title: The implications of lighted ureteral stenting in laparoscopic colectomy.
abstract: OBJECTIVE
  The placement of indwelling ureteral catheters during colorectal surgery has been recommended for prevention of ureteral injuries. With the advent of laparoscopic colectomy (LCo), the role of preoperative placement of lighted ureteral stents (LUS) has also become commonplace. We sought to evaluate the value of lighted ureteral stent placement in laparoscopic colectomy.
  
  
  METHODS
  Sixty-six patients underwent LCo with LUS inserted preoperatively. Stents were removed in the immediate postoperative period. Two surgeons performed all the colectomies; 32 patients were males and 34 were females. Fifty patients underwent sigmoid colectomy, 4 had abdominoperineal resection, 4 had right colectomy, and 1 each had transverse or subtotal colectomy. Eighteen patients had a diagnosis of cancer, 34 had diverticular disease, and 14 had neoplastic polyps. Forty patients had bilateral and 26 had unilateral stent placement. A review of the incidence of ureteral injuries, hematuria, and anuria as the cause of acute renal failure was accomplished, comparing the unilateral and bilateral stented groups.
  
  
  RESULTS
  One (1.5%) patient suffered a left ureteral laceration during sigmoid colectomy. This was managed successfully with stent reinsertion. Sixty-five (98.4%) patients had gross hematuria lasting 2.93 days (1 to 6 days). The cost of bilateral stent placement was $1,504.32. A statistically significant difference occurred in the duration of hematuria (days) between patients who had unilateral (2.5 +/- 0.82) and bilateral stent placement (3.37 +/- 1.05), (P < 0.001). Four patients suffered from anuria, 2 required renal support needing hemodialysis for 3 to 6 days, 3 (75%) had bilateral stents, and 1 (25%) had a unilateral stent.
  
  
  CONCLUSIONS
  We recommend the placement of lighted ureteral stents as a valuable adjunct to laparoscopic colectomy to safeguard ureteral integrity. Transient hematuria is common but requires no intervention. Reflux anuria occurs infrequently and is reversible.
authors: Department of Surgery, North Oakland Medical Centers, Pontiac, Michigan 48341, USA.
authors: Fadi
authors: F
authors: Chahin
authors: Amit J
authors: AJ
authors: Dwivedi
authors: Anil
authors: A
authors: Paramesh
authors: Wai
authors: W
authors: Chau
authors: Sunita
authors: S
authors: Agrawal
authors: Chadi
authors: C
authors: Chahin
authors: Anil
authors: A
authors: Kumar
authors: A
authors: A
authors: Tootla
authors: Farooq
authors: F
authors: Tootla
authors: Yvan J
authors: YJ
authors: Silva
mesh_terms: D003082:Colectomy / Q000009:adverse effects / Q000379:methods; D005260:Female; D006801:Humans; D007431:Intraoperative Complications / Q000517:prevention & control; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D008027:Light; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D012189:Retrospective Studies; D015607:Stents; D014513:Ureter / Q000293:injuries