Our Summary

This research paper investigates whether using ureteral catheters (small tubes inserted into the ureter to drain urine from the kidney to the bladder) during certain surgeries on the left side of the colon and rectum reduces the risk of ureteral injury (damage to the ureters). The research looked at data from the National Surgical Quality Improvement Project from 2012 to 2018.

The study found that, out of over 136,000 patients, those who had a ureteral catheter did not have a lower rate of ureteral injury than those who didn’t. In fact, using a catheter was linked to more overall complications and a longer surgery time.

However, the study did identify certain risk factors for ureteral injury, including being overweight, having an illness called diverticular disease, and needing to switch from a less invasive to a more invasive surgical technique. The researchers suggest that in cases where these risk factors are present, it could still be beneficial to use a ureteral catheter.

FAQs

  1. Does using a ureteral catheter during left-sided colon and rectum surgeries reduce the risk of ureteral injury?
  2. What are the identified risk factors for ureteral injury during these surgeries?
  3. Does the use of a ureteral catheter contribute to increased overall complications and longer surgery time?

Doctor’s Tip

One helpful tip a doctor might tell a patient about colectomy is to discuss the potential benefits and risks of using a ureteral catheter during the surgery. Depending on individual risk factors, it may or may not be necessary to have a catheter inserted. It’s important to have a thorough discussion with your healthcare team to determine the best course of action for your specific situation.

Suitable For

Patients who are typically recommended for colectomy include those with:

  1. Colon or rectal cancer
  2. Inflammatory bowel disease (such as Crohn’s disease or ulcerative colitis)
  3. Familial adenomatous polyposis (a genetic condition that causes numerous polyps in the colon)
  4. Severe diverticulitis (inflammation or infection of small pouches that form in the colon)
  5. Chronic constipation or bowel obstruction
  6. Intestinal ischemia (lack of blood flow to the intestines)
  7. Traumatic injury to the colon or rectum

Patients with these conditions may require a colectomy to remove part or all of the colon in order to treat their underlying condition and improve their quality of life.

Timeline

Before colectomy:

  • Patient undergoes preoperative evaluation, including medical history review and physical examination
  • Patient may undergo imaging tests such as colonoscopy, CT scans, or MRI to diagnose the condition necessitating colectomy
  • Patient may be prescribed a special diet and bowel preparation medication to clear the colon before surgery
  • Patient meets with the surgical team to discuss the procedure, risks, and recovery process

After colectomy:

  • Patient is closely monitored in the recovery room for any immediate complications
  • Patient may have a temporary colostomy or ileostomy to divert waste from the colon while it heals
  • Patient may experience pain, fatigue, and changes in bowel habits post-surgery
  • Patient undergoes follow-up appointments to monitor healing and address any complications
  • Patient may need to make dietary and lifestyle changes to adjust to life without a portion of their colon

Overall, the patient will experience a period of recovery and adjustment after colectomy, with ongoing medical care to ensure optimal healing and long-term well-being.

What to Ask Your Doctor

  1. What is a colectomy and why do I need one?
  2. What are the potential risks and complications of a colectomy?
  3. What are the different types of colectomy procedures and which one do you recommend for me?
  4. How long is the recovery process after a colectomy and what can I expect during that time?
  5. Will I need a ureteral catheter during the surgery and what are the potential benefits and risks of using one?
  6. Are there any specific risk factors for ureteral injury that apply to me?
  7. How will the presence of a ureteral catheter affect the overall outcome of my surgery?
  8. What are the alternative options to using a ureteral catheter during the surgery?
  9. How experienced are you in performing colectomy procedures and using ureteral catheters?
  10. Are there any specific instructions or precautions I should follow before and after the colectomy procedure?

Reference

Authors: Dolejs SC, Nicolas M, Maun DC, Lane FR, Waters JA, Tsai BM. Journal: Am J Surg. 2022 Mar;223(3):505-508. doi: 10.1016/j.amjsurg.2021.12.025. Epub 2021 Dec 27. PMID: 34996612