医源性尿路损伤 (IUI) 可导致结直肠手术后出现严重并发症，尤其是在诊断延迟时。本研究分析了接受结直肠手术的患者中与 IUI 和延迟 IUI 相关的危险因素。美国外科医生学会国家手术质量改进计划 (NSQIP®) 数据库中确定了 2012 年至 2021 年期间接受结直肠手术的成人。采用多变量回归分析确定与 IUI 和延迟 IUI 相关的危险因素和结果。 在 566,036 名患者中，5836 名患者 (1.0%) 在结直肠手术后发生了 IUI，其中 236 名 (4.0%) 发生了延迟 IUI。确定了 IUI 和延迟 IUI 的多个术前危险因素，其中包括播散性癌症 [调整后优势比 (aOR) 1.4，95% 置信区间 (CI) 1.2-1.5； p < 0.001] 和憩室病 [aOR 1.1，95% CI 1.0-1.2； p = 0.009] 与 IUI 和体重指数增加相关 [aOR 1.6，95% CI 1.2-2.1； p = 0.003] 和腹水 [aOR 5.6，95% CI 2.1-15.4； p = 0.001] 与延迟 IUI 相关。腹腔镜方法与 IUI 风险降低相关 [aOR 0.4，95% CI 0.4-0.5； p < 0.001] 且延迟 IUI 的风险增加 [aOR 1.8，95% CI 1.4-2.5； p < 0.001]。 IUI 和延迟 IUI 均与显着的术后发病率相关，延迟 IUI 中出现严重的多器官并发症。虽然 IUI 在结直肠手术中很少发生，但未被识别的损伤可能会使修复复杂化并导致其他不良术后结果。腹腔内病理复杂的患者进行 IUI 的风险增加，而接受腹腔镜手术的体型较大的患者延迟 IUI 的风险增加。© 2024。Springer Nature Switzerland AG。

Iatrogenic urinary injury (IUI) can lead to significant complications after colorectal surgery, especially when diagnosis is delayed. This study analyzes risk factors associated with IUI and delayed IUI among patients undergoing colorectal procedures.Adults undergoing colorectal surgery between 2012 and 2021 were identified in the American College of Surgeons National Surgical Quality Improvement Program (NSQIP®) database. Multivariable regression analysis was used to determine risk factors and outcomes associated with IUI and delayed IUI.Among 566,036 patients, 5836 patients (1.0%) had IUI after colorectal surgery, of whom 236 (4.0%) had delayed IUI. Multiple preoperative risk factors for IUI and delayed IUI were identified, with disseminated cancer [adjusted odds ratio (aOR) 1.4, 95% confidence interval (CI) 1.2-1.5; p < 0.001] and diverticular disease [aOR 1.1, 95% CI 1.0-1.2; p = 0.009] correlated with IUI and increased body mass index [aOR 1.6, 95% CI 1.2-2.1; p = 0.003] and ascites [aOR 5.6, 95% CI 2.1-15.4; p = 0.001] associated with delayed IUI. Laparoscopic approach was associated with decreased risk of IUI [aOR 0.4, 95% CI 0.4-0.5; p < 0.001] and increased risk of delayed IUI [aOR 1.8, 95% CI 1.4-2.5; p < 0.001]. Both IUI and delayed IUI were associated with significant postoperative morbidity, with severe multiorgan complications seen in delayed IUI.While IUI occurs infrequently in colorectal surgery, unrecognized injuries can complicate repair and cause other negative postoperative outcomes. Patients with complex intra-abdominal pathology are at increased risk of IUI, and patients with large body habitus undergoing laparoscopic procedures are at increased risk of delayed IUI.© 2024. Springer Nature Switzerland AG.