Sunnybrook Health Sciences Centre, University of Toronto
Morbidity and predictor for delayed recognition of Iatrogenic ureteric injuries
Jennifer A. Locke1, Sarah Neu1, Sender Herschorn1.
1Surgery, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
Introduction: Although iatrogenic ureteric injuries (IUI) are rare, intra-operatively unrecognized IUI can have significant consequences. The focus of our study is to characterize the associated morbidity and identify predictors of delayed recognition of IUI.
Methods: Sunnybrook Health Sciences Centre Research Ethics Board approved the study. Patients with a diagnosis of IUI between 2002 and 2020 were identified through an institutional electronic medical record system. Data pertaining to the demographic characteristics, diagnosis and management of IUI and overall outcomes was collected retrospectively.
Results: Of the 103 patients identified 83% were female, 52% had previous abdominal surgery and 18% had previous radiation. The median age was 67 (21- 88). Twenty percent had delayed recognition of IUI. Although delayed recognition was not a significant predictor for poor outcome after surgery (i.e. hydronephrosis, ureteric stricture/obstruction) it was associated with significant morbidity to the patient (i.e. additional procedures) and increased cost to the health care system (i.e. readmission to hospital). Patients who underwent laparoscopic surgery had an 11 times more likely chance of delayed presentation of IUI as compared to patients who underwent open surgery (OR=11.515, p=0.000).
Conclusions: Delayed recognition of IUI is associated with significant patient morbidity and cost to the health care system. In this retrospective case series we identified laparoscopic surgery as a predictor for delayed recognition of IUI. This information underscores the need for future studies to optimize intra-operative techniques to identify IUI, particularly in laparoscopic cases.
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|Pediatric and Adult Reconstruction||Impact of Delayed Recognition of Iatrogenic Ureteric Injury in a Retrospective Population-Based Study||TBD|
||Unmoderated Posters||Morbidity and Predictor for Delayed Recognition of Iatrogenic Ureteric Injuries||TBD|