Postoperative urinary dysfunction following lateral lymph node dissection for rectal cancer via minimally invasive...

Area of Science:

• Oncology
• Surgical Innovation
• Urology

Background:

• Lateral lymph node dissection (LLND) is crucial for locally advanced rectal cancer (LARC) to reduce recurrence but poses risks of urinary dysfunction.
• Minimally invasive techniques like laparoscopic surgery (LS) and robot-assisted LS (RALS) are increasingly used for LARC procedures.

Purpose of the Study:

• To compare postoperative urinary dysfunction between LS and RALS following LLND for LARC.
• To identify independent risk factors associated with prolonged urinary catheterization after LLND in LARC patients.

Main Methods:

• A retrospective study of 100 LARC patients who underwent LS or RALS with LLND.
• Postoperative urinary dysfunction was evaluated by the duration of urinary catheterization (DUC), with "long-term" defined as >5 days.
• Clinicopathological factors and surgical details were analyzed to identify predictors of DUC.

Main Results:

• No significant difference in urinary dysfunction was observed between LS and RALS groups.
• Bilateral LLND was associated with significantly longer DUC compared to unilateral LLND.
• Surgical site infection (SSI) independently increased the risk of prolonged urinary catheterization.

Conclusions:

• Neither LS nor RALS demonstrates an advantage in preventing urinary dysfunction post-LLND for LARC.
• Bilateral LLND and perioperative SSI are significant risk factors for prolonged urinary catheterization.
• Selective, predominantly unilateral LLND and robust SSI prevention are recommended to preserve urinary function.