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Retzius-Sparing Robot-Assisted Radical Prostatectomy
Published on: May 19, 2022
Rectal injury during radical prostatectomy.
Mehmet Yıldırım1, Cemal Göktaş, Rahim Horuz
1Department of General Surgery, Dr. Lütfi Kırdar Kartal Training and Research Hospital, İstanbul, Turkey.
Summary
Iatrogenic rectal injury during radical prostatectomy (RP) can be effectively treated with primary double-layered suturing if recognized intraoperatively. This method avoids the need for colostomy in most cases.
Area of Science:
- Urology
- Surgical Oncology
- Gastrointestinal Surgery
Background:
- Radical prostatectomy (RP) carries a risk of iatrogenic rectal injury.
- Evaluating outcomes of rectal injuries during RP is crucial for surgical practice.
Purpose of the Study:
- To assess the management and outcomes of rectal injuries occurring during radical prostatectomy.
- To determine the efficacy of primary repair for intraoperatively recognized rectal injuries.
Main Methods:
- Retrospective analysis of 7 patients with iatrogenic rectal injury from 451 RP cases (2003-2011).
- Data collected on patient demographics, injury location, repair technique, and postoperative outcomes.
Main Results:
- Mean patient age was 64.4 years.
- Injuries occurred during various dissection steps; mean lesion size was 2 cm.
- All injuries were repaired intraoperatively with double-layered sutures; no colostomies were required.
- 6 out of 7 patients had no postoperative complications; 1 required reoperation due to dehiscence.
- No urethrorectal fistulas, urinary incontinence, or urethral strictures were observed.
Conclusions:
- Intraoperatively recognized rectal injuries during RP can be successfully treated with primary double-layered suturing.
- This approach is effective in preventing major postoperative complications like fistula or incontinence.
