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01-02-2022 | Rectal Cancer

Long-term effects of laparoscopic lateral pelvic lymph node dissection on urinary retention in rectal cancer

Authors: Yoshihiko Sadakari, Kyoko Hisano, Masafumi Sada, Yusuke Mizuuchi, Kinuko Nagayoshi, Hayato Fujita, Shuntaro Nagai, Tatsuya Manabe, Takashi Ueki, Masafumi Nakamura

Published in: Surgical Endoscopy | Issue 2/2022

Abstract

Background

The addition of lateral pelvic lymph node dissection (LPLND) in rectal cancer surgery has been reported to increase the incidence of post-operative urinary retention. Here, we assessed the predictive factors and long-term outcomes of urinary retention following laparoscopic LPLND (L-LPLND) with total mesorectal excision (TME) for advanced lower rectal cancer.

Methods

This retrospective single-institutional study reviewed post-operative urinary retention in 71 patients with lower rectal cancer who underwent L-LPLND with TME. Patients with preoperative urinary dysfunction or who underwent unilateral LPLND were excluded. Detailed information regarding patient clinicopathologic characteristics, post-void residual urine volume, and the presence or absence of urinary retention over time was collected from clinical and histopathologic reports and telephone surveys. Urinary retention was defined as residual urine > 100 mL and the need for further treatment.

Results

Post-operative urinary retention was observed in 25/71 patients (35.2%). Multivariate analysis revealed that blood loss ≥ 400 mL [odds ratio (OR) 4.52; 95% confidence interval (CI) 1.24–16.43; p = 0.018] and inferior vesical artery (IVA) resection (OR 8.28; 95% CI 2.46–27.81; p < 0.001) were independently correlated with the incidence of urinary retention. Furthermore, bilateral IVA resection caused urinary retention in more patients than unilateral IVA resection (88.9% vs 47.1%, respectively; p = 0.049). Although urinary retention associated with unilateral IVA resection improved relatively quickly, urinary retention associated with bilateral IVA resection tended to persist over 1 year.

Conclusion

We identified the predictive factors of urinary retention following L-LPLND with TME, including increased blood loss (≥ 400 mL) and IVA resection. Urinary retention associated with unilateral IVA resection improved relatively quickly. L-LPLND with unilateral IVA resection is a feasible and safe procedure to improve oncological curability. However, if oncological curability is guaranteed, bilateral IVA resection should be avoided to prevent irreversible urinary retention.

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Title: Long-term effects of laparoscopic lateral pelvic lymph node dissection on urinary retention in rectal cancer
Authors: Yoshihiko Sadakari
Kyoko Hisano
Masafumi Sada
Yusuke Mizuuchi
Kinuko Nagayoshi
Hayato Fujita
Shuntaro Nagai
Tatsuya Manabe
Takashi Ueki
Masafumi Nakamura
Publication date: 01-02-2022
Publisher: Springer US
Keywords: Rectal Cancer
Laparoscopy
Rectal Cancer
Published in: Surgical Endoscopy / Issue 2/2022
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-021-08364-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Long-term effects of laparoscopic lateral pelvic lymph node dissection on urinary retention in rectal cancer

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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