World Journal of Emergency Surgery (Sep 2023)
2023 WSES guidelines for the prevention, detection, and management of iatrogenic urinary tract injuries (IUTIs) during emergency digestive surgery
- Nicola de’Angelis,
- Carlo Alberto Schena,
- Francesco Marchegiani,
- Elisa Reitano,
- Belinda De Simone,
- Geoffrey Yuet Mun Wong,
- Aleix Martínez-Pérez,
- Fikri M. Abu-Zidan,
- Vanni Agnoletti,
- Filippo Aisoni,
- Michele Ammendola,
- Luca Ansaloni,
- Miklosh Bala,
- Walter Biffl,
- Graziano Ceccarelli,
- Marco Ceresoli,
- Osvaldo Chiara,
- Massimo Chiarugi,
- Stefania Cimbanassi,
- Federico Coccolini,
- Raul Coimbra,
- Salomone Di Saverio,
- Michele Diana,
- Marco Dioguardi Burgio,
- Gustavo Fraga,
- Paschalis Gavriilidis,
- Angela Gurrado,
- Riccardo Inchingolo,
- Alexandre Ingels,
- Rao Ivatury,
- Jeffry L. Kashuk,
- Jim Khan,
- Andrew W. Kirkpatrick,
- Fernando J. Kim,
- Yoram Kluger,
- Zaher Lakkis,
- Ari Leppäniemi,
- Ronald V. Maier,
- Riccardo Memeo,
- Ernest E. Moore,
- Carlos A. Ordoñez,
- Andrew B. Peitzman,
- Gianluca Pellino,
- Edoardo Picetti,
- Manos Pikoulis,
- Michele Pisano,
- Mauro Podda,
- Oreste Romeo,
- Fausto Rosa,
- Edward Tan,
- Richard P. Ten Broek,
- Mario Testini,
- Brian Anthony Tian Wei Cheng,
- Dieter Weber,
- Emilio Sacco,
- Massimo Sartelli,
- Alfredo Tonsi,
- Fabrizio Dal Moro,
- Fausto Catena
Affiliations
- Nicola de’Angelis
- Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP
- Carlo Alberto Schena
- Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP
- Francesco Marchegiani
- Unit of Colorectal and Digestive Surgery, DIGEST Department, Beaujon University Hospital, AP-HP
- Elisa Reitano
- Department of General Surgery, Nouvel Hôpital Civil, CHRU-Strasbourg, Research Institute Against Digestive Cancer (IRCAD)
- Belinda De Simone
- Department of Minimally Invasive Surgery, Guastalla Hospital, AUSL-IRCCS Reggio
- Geoffrey Yuet Mun Wong
- Department of Upper Gastrointestinal Surgery, Royal North Shore Hospital
- Aleix Martínez-Pérez
- Unit of Colorectal Surgery, Department of General and Digestive Surgery, Hospital Universitario Doctor Peset
- Fikri M. Abu-Zidan
- The Research Office, College of Medicine and Health Sciences, United Arab Emirates University
- Vanni Agnoletti
- Department of General and Emergency Surgery, Bufalini Hospital‐Level 1 Trauma Center
- Filippo Aisoni
- Department of Morphology, Surgery and Experimental Medicine, Università Degli Studi Di Ferrara
- Michele Ammendola
- Science of Health Department, Digestive Surgery Unit, University “Magna Graecia” Medical School
- Luca Ansaloni
- Department of General Surgery, IRCCS Policlinico San Matteo Foundation
- Miklosh Bala
- Acute Care Surgery and Trauma Unit, Department of General Surgery, Hadassah Medical Center and Faculty of Medicine, Hebrew University of Jerusalem Kiriat Hadassah
- Walter Biffl
- Division of Trauma/Acute Care Surgery, Scripps Clinic Medical Group
- Graziano Ceccarelli
- General Surgery, San Giovanni Battista Hospital
- Marco Ceresoli
- General and Emergency Surgery, School of Medicine and Surgery, Milano-Bicocca University
- Osvaldo Chiara
- General Surgery and Trauma Team, ASST Niguarda Milano, University of Milano
- Massimo Chiarugi
- General, Emergency and Trauma Department, Pisa University Hospital
- Stefania Cimbanassi
- General Surgery and Trauma Team, ASST Niguarda Milano, University of Milano
- Federico Coccolini
- General, Emergency and Trauma Department, Pisa University Hospital
- Raul Coimbra
- Riverside University Health System Medical Center
- Salomone Di Saverio
- Unit of General Surgery, San Benedetto del Tronto Hospital
- Michele Diana
- Department of General Surgery, Nouvel Hôpital Civil, CHRU-Strasbourg, Research Institute Against Digestive Cancer (IRCAD)
- Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon
- Gustavo Fraga
- Department of Trauma and Acute Care Surgery, University of Campinas
- Paschalis Gavriilidis
- Department of HBP Surgery, University Hospitals Coventry and Warwickshire NHS Trust
- Angela Gurrado
- Department of Precision and Regenerative Medicine and Ionian Area, Unit of Academic General Surgery “V. Bonomo”, University of Bari “A. Moro”
- Riccardo Inchingolo
- Unit of Interventional Radiology, F. Miulli Hospital
- Alexandre Ingels
- Department of Urology, Henri Mondor Hospital, University of Paris Est Créteil (UPEC)
- Rao Ivatury
- Professor Emeritus, Virginia Commonwealth University
- Jeffry L. Kashuk
- Department of Surgery, Sackler School of Medicine, Tel Aviv University
- Jim Khan
- Department of Colorectal Surgery, Queen Alexandra Hospital, University of Portsmouth
- Andrew W. Kirkpatrick
- Departments of Surgery and Critical Care Medicine, University of Calgary, Foothills Medical Centre
- Fernando J. Kim
- Division of Urology, Denver Health Medical Center
- Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus
- Zaher Lakkis
- Department of Digestive Surgical Oncology - Liver Transplantation Unit, University Hospital of Besançon
- Ari Leppäniemi
- Abdominal Center, Helsinki University Hospital and University of Helsinki
- Ronald V. Maier
- Harborview Medical Center, University of Washington
- Riccardo Memeo
- Unit of Hepato‐Pancreato‐Biliary Surgery, General Regional Hospital “F. Miulli”
- Ernest E. Moore
- Ernest E. Moore Shock Trauma Center at Denver Health, University of Colorado
- Carlos A. Ordoñez
- Division of Trauma and Acute Care Surgery, Fundación Valle del Lili
- Andrew B. Peitzman
- Department of Surgery, University of Pittsburgh School of Medicine, UPMC-Presbyterian
- Gianluca Pellino
- Colorectal Surgery Unit, Vall d’Hebron University Hospital, Universitat Autònoma de Barcelona
- Edoardo Picetti
- Department of Anesthesia and Intensive Care, Parma University Hospital
- Manos Pikoulis
- 3rd Department of Surgery, Attikon General Hospital, National and Kapodistrian University of Athens (NKUA)
- Michele Pisano
- 1st General Surgery Unit, Department of Emergency, ASST Papa Giovanni Hospital Bergamo
- Mauro Podda
- Department of Emergency Surgery, Cagliari University Hospital
- Oreste Romeo
- Bronson Trauma Surgery
- Fausto Rosa
- Emergency and Trauma Surgery Unit, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Edward Tan
- Department of Surgery, Radboud University Medical Center
- Richard P. Ten Broek
- John Hunter Hospital, University of Newcastle
- Mario Testini
- Department of Precision and Regenerative Medicine and Ionian Area, Unit of Academic General Surgery “V. Bonomo”, University of Bari “A. Moro”
- Brian Anthony Tian Wei Cheng
- Department of Surgery, Singapore General Hospital
- Dieter Weber
- Department of Trauma Surgery, Royal Perth Hospital
- Emilio Sacco
- Department of Urology, Università Cattolica del Sacro Cuore Di Roma, Fondazione Policlinico Universitario Agostino Gemelli IRCCS
- Massimo Sartelli
- Department of Surgery, Macerata Hospital
- Alfredo Tonsi
- Digestive Diseases Department, Royal Sussex County Hospital, University Hospitals Sussex
- Fabrizio Dal Moro
- Department of Surgery, Oncology and Gastroenterology, University of Padua
- Fausto Catena
- Department of General and Emergency Surgery, Bufalini Hospital‐Level 1 Trauma Center
- DOI
- https://doi.org/10.1186/s13017-023-00513-8
- Journal volume & issue
-
Vol. 18,
no. 1
pp. 1 – 23
Abstract
Abstract Iatrogenic urinary tract injury (IUTI) is a severe complication of emergency digestive surgery. It can lead to increased postoperative morbidity and mortality and have a long-term impact on the quality of life. The reported incidence of IUTIs varies greatly among the studies, ranging from 0.3 to 1.5%. Given the high volume of emergency digestive surgery performed worldwide, there is a need for well-defined and effective strategies to prevent and manage IUTIs. Currently, there is a lack of consensus regarding the prevention, detection, and management of IUTIs in the emergency setting. The present guidelines, promoted by the World Society of Emergency Surgery (WSES), were developed following a systematic review of the literature and an international expert panel discussion. The primary aim of these WSES guidelines is to provide evidence-based recommendations to support clinicians and surgeons in the prevention, detection, and management of IUTIs during emergency digestive surgery. The following key aspects were considered: (1) effectiveness of preventive interventions for IUTIs during emergency digestive surgery; (2) intra-operative detection of IUTIs and appropriate management strategies; (3) postoperative detection of IUTIs and appropriate management strategies and timing; and (4) effectiveness of antibiotic therapy (including type and duration) in case of IUTIs.
Keywords
- Iatrogenic urinary tract injury
- Ureteral injury
- Bladder injury
- Urinary injury prevention
- Urinary injury diagnosis
- Urinary injury management
