Top

Published in:

01-08-2020 | Rectal Cancer

Male sex and anterior wall tumor location as risk factors for urinary dysfunction after laparoscopic rectal surgery

Authors: Hiroki Hamamoto, Masashi Yamamoto, Shinsuke Masubuchi, Masatsugu Ishii, Wataru Osumi, Keitaro Tanaka, Junji Okuda, Kazuhisa Uchiyama

Published in: Surgical Endoscopy | Issue 8/2020

Abstract

Background

Total mesorectal excision (TME) has decreased the local recurrence rate and improved the overall survival of rectal cancer patients. However, urinary dysfunction remains a clinical problem after rectal cancer surgery. The aim was to assess the risk factors for postoperative urinary dysfunction.

Methods

This study was a single-center, retrospective analysis of 104 patients who underwent laparoscopic rectal surgery between November 2016 and October 2017. Postoperative urinary dysfunction was defined as the need for urinary catheter re-insertion or the presence of residual urine (≥ 150 mL) postoperatively.

Results

Postoperative urinary dysfunction was seen in 18 patients (17%). Multivariate analysis showed that male sex (odds ratio 3.89, p = 0.034) and anterior wall tumor location (odds ratio = 4.07, p = 0.037) were the predictors of postoperative urinary dysfunction. Compared with patients without risk factors, those with the two risk factors needed longer hospital stays (16 days vs. 30 days, p = 0.0022).

Conclusion

Male sex and anterior wall tumor location were the risk factors for urinary dysfunction after laparoscopic rectal surgery.

Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1:1479–1482CrossRef

MacFarlane JK, Ryall RD, Heald RJ (1993) Mesorectal excision for rectal cancer. Lancet 341:457–460CrossRef

Maas CP, Moriya Y, Steup WH, Kiebert GM, Kranenbarg WM, van de Velde CJ (1998) Radical and nerve-preserving surgery for rectal cancer in The Netherlands: a prospective study on morbidity and functional outcome. Br J Surg 85:92–97CrossRef

Nesbakken A, Nygaard K, Bull-Njaa T, Carlsen E, Eri LM (2000) Bladder and sexual dysfunction after mesorectal excision for rectal cancer. Br J Surg 87:206–210CrossRef

Doeksen A, Gooszen JA, Van Duijvendijk P, Tanis PJ, Bakx R, Slors JF, van Lanschot JJ (2011) Sexual and urinary functioning after rectal surgery: a prospective comparative study with a median follow-up of 8.5 years. Int J Color Dis 26:1549–1557CrossRef

Peeters KC, van de Velde CJ, Leer JW, Martijn H, Junggeburt JM, Kranenbarg EK, Steup WH, Wiggers T, Rutten HJ, Marijnen CA (2005) Late side effects of short-course preoperative radiotherapy combined with total mesorectal excision for rectal cancer: increased bowel dysfunction in irradiated patients—a Dutch colorectal cancer group study. J Clin Oncol 23:6199–6206CrossRef

Pollack J, Holm T, Cedermark B, Altman D, Holmström B, Glimelius B, Mellgren A (2006) Late adverse effects of short-course preoperative radiotherapy in rectal cancer. Br J Surg 93:1519–1525CrossRef

Ito M, Kobayashi A, Fujita S, Mizusawa J, Kanemitsu Y, Kinugasa Y, Komori K, Ohue M, Ota M, Akazai Y, Shiozawa M, Yamaguchi T, Akasu T, Moriya Y, Colorectal Cancer Study Group of Japan Clinical Oncology Group (2018) Urinary dysfunction after rectal cancer surgery: results from a randomized trial comparing mesorectal excision with and without lateral lymph node dissection for clinical stage II or III lower rectal cancer (Japan Clinical Oncology Group Study, JCOG0212). Eur J Surg Oncol 44:463–468CrossRef

Shiomi A, Kinugasa Y, Yamaguchi T, Tomioka H, Kagawa H (2014) Robot-assisted rectal cancer surgery: short-term outcomes for 113 consecutive patients. Int J Colorectal Dis 29:1105–1111CrossRef

10.

Yamaguchi T, Kinugasa Y, Shiomi A, Tomioka H, Kagawa H (2016) Robotic-assisted laparoscopic versus open lateral lymph node dissection for advanced lower rectal cancer. Surg Endosc 30:721–728CrossRef

11.

Lee SY, Kang SB, Kim DW, Oh HK, Ihn MH (2015) Risk factors and preventive measures for acute urinary retention after rectal cancer surgery. World J Surg 39:275–282CrossRef

12.

Kwaan MR, Lee JT, Rothenberger DA, Melton GB, Madoff RD (2015) Early removal of urinary catheters after rectal surgery is associated with increased urinary retention. Dis Colon Rectum 58:401–405CrossRef

13.

Kim HO, Cho YS, Kim H, Lee SR, Jung KU, Chun HK (2016) Scoring systems used to predict bladder dysfunction after laparoscopic rectal cancer surgery. World J Surg 40:3044–3051CrossRef

14.

Cécile BD, Jérémie HL, Malika B, Najim C, Emmanuel T, Yann P (2016) Management of postoperative bladder emptying after proctectomy in men for rectal cancer. A retrospective study of 190 consecutive patients. Int J Colorectal Dis 31:511–518CrossRef

15.

Kinugasa Y, Murakami G, Suzuki D, Sugihara K (2007) Histological identification of fascial structures posterolateral to the rectum. Br J Surg 94:620–626CrossRef

16.

Costello AJ, Brooks M, Cole OJ (2004) Anatomical studies of the neurovascular bundle and cavernosal nerves. BJU Int 94:1071–1076CrossRef

17.

Japanese Society for Cancer of the Colon and Rectum (2018) The guidelines for therapy of colorectal cancer, 9th edn. Kanehara Shuppan, Tokyo

18.

Kayano H, Okuda J, Tanaka K, Kondo K, Tanigawa N (2011) Evaluation of the learning curve in laparoscopic low anterior resection for rectal cancer. Surg Endosc 25:2972–2979CrossRef

19.

NCCN Clinical Practice Guidelines in Oncology (NCCN Guideline^®), Version 3.2108 https://www.nccn.org/professionals/physician_gls/pdf/rectal.pdf. Accessed 11 June 2019

20.

Glynne-Jones R, Wyrwicz L, Tiret E, Brown G, Rödel C, Cervantes A, Arnold D, Guidelines Committee ESMO (2017) Rectal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 28:22–40CrossRef

21.

Lange MM, Maas CP, Marijnen CA, Wiggers T, Rutten HJ, Kranenbarg EK, van de Velde CJ, Cooperative Clinical Investigators of the Dutch Total Mesorectal Excision Trial (2008) Urinary dysfunction after rectal cancer treatment is mainly caused by surgery. Br J Surg 95:1020–1028CrossRef

22.

Kim JY, Kim NK, Lee KY, Hur H, Min BS, Kim JH (2012) A comparative study of voiding and sexual function after total mesorectal excision with autonomic nerve preservation for rectal cancer: laparoscopic versus robotic surgery. Ann Surg Oncol 19:2485–2493CrossRef

23.

Gustafsson UO, Scott MJ, Hubner M, Nygren J, Demartines N, Francis N, Rockall TA, Young-Fadok TM, Hill AG, Soop M, de Boer HD, Urman RD, Chang GJ, Fichera A, Kessler H, Grass F, Whang EE, Fawcett WJ, Carli F, Lobo DN, Rollins KE, Balfour A, Baldini G, Riedel B, Ljungqvist O (2019) Guidelines for perioperative care in elective colorectal surgery: enhanced recovery after surgery (ERAS^®) society recommendations: 2018. World J Surg 43:659–695CrossRef

24.

Yoo BE, Kye BH, Kim HJ, Kim G, Kim JG, Cho HM (2015) Early removal of the urinary catheter after total or tumor-specific mesorectal excision for rectal cancer is safe. Dis Colon Rectum 58:686–691CrossRef

25.

Nagao S, Saida Y, Enomoto T, Takahashi A, Higuchi T, Moriyama H, Niituma T, Watanabe M, Asai K, Kusachi S (2018) Prospective short-term feasibility study of perioperative suprapubic catheters in laparoscopic colectomy. Asian J Endosc Surg 12:64–68CrossRef

26.

Georgiou P, Tan E, Gouvas N, Antoniou A, Brown G, Nicholls RJ, Tekkis P (2009) Extended lymphadenectomy versus conventional surgery for rectal cancer: a meta-analysis. Lancet Oncol 10:1053–1062CrossRef

27.

Moriya Y, Sugihara K, Akasu T, Fujita S (1995) Nerve-sparing surgery with lateral node dissection for advanced lower rectal cancer. Eur J Cancer 31:1229–1232CrossRef

Title: Male sex and anterior wall tumor location as risk factors for urinary dysfunction after laparoscopic rectal surgery
Authors: Hiroki Hamamoto
Masashi Yamamoto
Shinsuke Masubuchi
Masatsugu Ishii
Wataru Osumi
Keitaro Tanaka
Junji Okuda
Kazuhisa Uchiyama
Publication date: 01-08-2020
Publisher: Springer US
Keywords: Rectal Cancer
Rectal Cancer
Published in: Surgical Endoscopy / Issue 8/2020
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-019-07186-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Male sex and anterior wall tumor location as risk factors for urinary dysfunction after laparoscopic rectal surgery

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

Please log in to get access to this content

Other articles of this Issue 8/2020

Clinical efficacy of gastric per-oral endoscopic myotomy (G-POEM) in the treatment of refractory gastroparesis and predictors of outcomes: a systematic review and meta-analysis using surgical pyloroplasty as a comparator group

The role of preoperative workup in predicting dysphagia, dilation, or explantation after magnetic sphincter augmentation

Does endoscopic sleeve gastroplasty stand the test of time? Objective assessment of endoscopic ESG appearance and its relation to weight loss in a large group of consecutive patients

A randomized controlled trial comparing right and left lateral decubitus starting position on outcomes in colonoscopy

Transabdominal (TA) versus totally extraperitoneal (TEP) robotic retromuscular ventral hernia repair: a propensity score matching analysis

Educational value of telementoring for a simulation-based fundamental use of surgical energy™ (FUSE) curriculum: a randomized controlled trial in surgical trainees