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Association between urinary function and resected pattern of the autonomic nerve system after transanal total mesorectal excision for rectal cancer
Author(s) -
Shiraishi Takuya,
Ito Masaaki,
Sasaki Takeshi,
Nishizawa Yuji,
Tsukada Yuichiro,
Ikeda Koji
Publication year - 2021
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.15416
Subject(s) - medicine , urinary system , total mesorectal excision , surgery , colorectal cancer , urinary retention , urology , cancer
Abstract Aim Transanal total mesorectal excision (TaTME) is expected to improve the quality of total mesorectal excision as well as preserve urinary function. We aimed to study the frequency and risk factors of urinary dysfunction in rectal cancer patients after TaTME. Moreover, we analysed the association between urinary function and resected pattern of the autonomic nerve system (ANS) in TaTME. Method We retrospectively analysed 231 patients who underwent TaTME at our hospital from 2013 to 2018. Independent risk factors for urinary dysfunction were assessed by multivariate analysis. Urinary dysfunction was defined as a condition that requires urethral catheterisation. We intraoperatively judged and classified the preserved or resected pattern of ANS into four categories. Results The rate of urinary dysfunction after TaTME was 12.1% at discharge. Multivariate analysis revealed that beyond TME and ANS resection were the two major independent risk factors for urinary dysfunction. Total ANS preservation had reduced rates of urinary dysfunction, and all patients were free from catheterisation 6 months post‐surgery. There was a higher rate of urinary dysfunction in total ANS resection than in partial ANS resection at 6 months post‐surgery. Conclusion This study showed that urinary function after TaTME was associated with resection of the ANS. Furthermore, the rate of urinary dysfunction and recovery time were closely related to the pattern of ANS resection.