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Lower Incidence of Postoperative Urinary Retention in Robotic Total Mesorectal Excision for Low Rectal Cancer Compared with Laparoscopic Surgery

Authors
Lee, Tae HoonKwak, Jung-MyunYu, Da YoungYang, Kyung-SookBaek, Se JinKim, JinKim, Seon Hahn
Issue Date
Jun-2022
Publisher
Karger AG
Keywords
Urinary retention; Rectal cancer; Total mesorectal excision; Robotic colorectal surgery; Laparoscopic colorectal surgery
Citation
Digestive Surgery, v.39, no.2-3, pp.75 - 82
Indexed
SCIE
SCOPUS
Journal Title
Digestive Surgery
Volume
39
Number
2-3
Start Page
75
End Page
82
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61367
DOI
10.1159/000522229
ISSN
0253-4886
Abstract
Introduction: The incidence and clinical significance of postoperative urinary retention (POUR) remain high. This study aimed to evaluate the incidence of POUR and related risk factors in patients who underwent total mesorectal excision (TMR) for low rectal cancer. Methods: This study is a retrospective review of a prospectively collected colorectal database from a single center. Data from patients who underwent surgery for low rectal cancer between September 2006 and May 2017 were analyzed to assess the risk factors of POUR. POUR was considered inability to void after urinary catheter removal requiring catheter reinsertion and difficulty in bladder emptying requiring intermittent catheterization. Results: Of 555 patients with low rectal cancer, 78 (14.1%) developed POUR. Based on multivariate logistic regression analysis, laparoscopic TMR (odds ratio [OR]; 2.114, 95% confidence interval [CI]; 1.212-3.689, p = 0.008) and postoperative ileus (OR; 2.389, 95% CI; 1.282-4.450, p = 0.006) were independent risk factors of POUR. Male gender, advanced age, neoadjuvant chemoradiation, longer operative time, abdominoperineal resection, and lateral pelvic lymph node dissection were not associated with POUR. Advanced age over 65 years also failed to show statistical significance (OR; 1.604, 95% CI; 0.965-2.668, p= 0.068). Conclusion: Laparoscopic approach and postoperative ileus are risk factors for POUR after low rectal cancer surgery. We postulate that the benefits of robotic surgical systems compared to a laparoscopic approach may reduce the incidence of POUR.
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2. Clinical Science > Department of Breast and Endocrine Surgery > 1. Journal Articles
2. Clinical Science > Department of Colon and Rectal Surgery > 1. Journal Articles

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Anam Hospital (Department of Colon and Rectal Surgery, Anam Hospital)
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