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Pelvic dimension as a predictor of ureteral injury in gynecological cancer surgeries

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Abstract

Background

Ureteral injury is an intractable complication in gynecological cancer surgeries. Identifying risk factors can ensure safety of the ureters intraoperatively. A narrow pelvis is known to exert extra difficulties in pelvic surgeries. However, whether pelvic dimension can affect the risk of ureteral injury in gynecological cancer surgeries is poorly understood. We aimed to evaluate the association between pelvic dimension and the risk of ureteral injury during gynecological cancer surgeries.

Methods

All patients who had undergone gynecological cancer surgeries were searched from January 2011 to July 2017. We included patients with ureteral injury who had available data of abdominal and pelvic computed tomography for measuring pelvic dimensions. Multivariate condition logistic analysis was used to identify the risk factors independently correlated with ureteral injury in gynecological cancer surgeries.

Results

A total of 43 cases with 86 controls were included in this study. We discovered that a longer anteroposterior diameter of the mid-pelvis (odds ratio [OR] 1.07, 95% confidence interval [CI] 1.01–1.13, P = 0.019) and a shorter transverse diameter of the mid-pelvis (OR 0.92, 95% CI 0.86–0.98, P = 0.013) were associated with ureteral injury in gynecological cancer surgeries. In laparoscopic analysis, a longer anteroposterior diameter of the mid-pelvis (OR 1.11, 95% CI 1.00–1.24, P = 0.041) was a risk factor for ureteral injury. In the analysis of open surgery, a longer transverse diameter of the mid-pelvis (OR 0.79, 95% CI 0.66–0.93, P = 0.006) was a protective factor for ureteral injury.

Conclusions

This study demonstrated that mid-pelvis dimensions were associated with ureteral injury, but the observed differences were too small. In addition, pelvic inlet dimensions did not appear to relate with ureteral injury. Thus, these pelvimetry measures could not be beneficial in assessing the risk of ureteral injury in gynecological cancer surgeries.

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Acknowledgements

The authors thank Xuesai Gu, Information Management Department, West China Second University Hospital, Sichuan University for searching original data; Peiyuan Qiu, West China School of Public Health, and Sichuan University for help in statistical analysis.

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Author notes

  1. Hui Ye, Di You and Lin Li have contributed equally to this work.

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, West China Second University Hospital, Sichuan University, Number 20, Third Section of People’s South Road, Chengdu, 610000, China

    Hui Ye, Di You, Lin Li, Hanyu Cao & Mingrong Xi

  2. Department of Urology, West China Hospital, Sichuan University, Chengdu, China

    Deyi Luo & Hong Shen

  3. Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, China

    Huizhu Chen

  4. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China

    Mingrong Xi

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  1. Hui Ye
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Correspondence to Mingrong Xi.

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Dr. Hui Ye, Di You, Lin Li, Hanyu Cao, Deyi Luo, Hong Shen, Huizhu Chen, and Mingrong Xi have no conflicts of interest or financial ties to disclose.

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Ye, H., You, D., Li, L. et al. Pelvic dimension as a predictor of ureteral injury in gynecological cancer surgeries. Surg Endosc 34, 3920–3926 (2020). https://doi.org/10.1007/s00464-019-07162-6

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  • DOI: https://doi.org/10.1007/s00464-019-07162-6

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