Urological Outcomes and Adverse Events Following Total Pelvic Exenteration for Locally Advanced and Recurrent Rectal Cancer: A Single-center Retrospective Study

IF 2.1 3区医学 Q2 UROLOGY & NEPHROLOGY

Urology Pub Date : 2025-04-01 DOI:10.1016/j.urology.2024.12.021

Nikki Kerdegari , Calum T. Singh , Findlay MacAskill , Christopher Allen , Sachin Malde , Rajesh Nair , Ramesh Thurairaja , Muhammad S. Khan , Mark George , Alexis Schizas , Arun Sahai

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引用次数: 0

Abstract

Objective

To assess urological complications in patients undergoing total pelvic exenteration (TPE) for locally advanced (LARC) and recurrent rectal cancer (RRC) as publications in this area are limited. Secondary objectives were to assess whether LARC vs RRC or radiation status affected urological outcomes.

Methods

Single-center, retrospective study of TPE patients between January 2017 and December 2022. Electronic records were evaluated to extract data. Postoperative outcomes were analyzed using two-tailed t-tests, Mann-Whitney U tests and chi-squared tests. Urological complications were analyzed using simple logistic regression.

Results

A total of 128 patients underwent TPE (97 LARC, 31 RRC). 90 (70.3%) received neoadjuvant radiotherapy. The overall urological complication rate was 51.6%. Transient acute kidney injury and urinary tract infection were the two most common complications occurring in 38 (29.7%) and 33 (25.8%) respectively. 23 (18.0%) had at least one major complication of Clavien-Dindo III/IV related to the urinary system. Ureteroenteric stricture rate was 7.0% and 14.1% needed a reoperation for urological complications. There was no association between the overall incidence of urological complications and radiation status (OR 0.81 [0.37-1.73], P = .586) or between patients with LARC and RRC (OR 1.68 [0.75-3.93], P = .216).

Conclusion

Urological complications are common post-TPE. The urological complication rate is similar in LARC and RRC and radiation status did not affect outcomes in this cohort.

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局部晚期和复发性直肠癌全盆腔切除术后泌尿系统预后和不良事件：一项单中心回顾性研究。

目的：评估局部晚期（LARC）和复发性直肠癌（RRC）患者行全盆腔切除术（TPE）的泌尿系统并发症，因为该领域的出版物有限。次要目的是评估LARC与RRC或放射状态是否影响泌尿系统预后。方法：2017年1月至2022年12月对TPE患者进行单中心回顾性研究。评估电子记录以提取数据。术后结果分析采用双尾t检验、Mann-Whitney U检验和卡方检验。泌尿系统并发症采用简单逻辑回归分析。结果：128例患者行TPE （LARC 97例，RRC 31例）。90例（70.3%）接受新辅助放疗。泌尿系统并发症总发生率为51.6%。短暂性急性肾损伤（AKI）和尿路感染（UTI）是两种最常见的并发症，分别发生38例（29.7%）和33例（25.8%）。23例（18.0%）至少有一种与泌尿系统相关的Clavien-Dindo III/IV主要并发症。输尿管肠狭窄率为7.0%，因泌尿外科并发症再次手术的占14.1%。泌尿系统并发症的总发生率与放疗状况之间无相关性（OR为0.81 [0.37 - 1.73],p = 0.586）， LARC与RRC患者之间无相关性（OR为1.68 [0.75 - 3.93],p = 0.216）。结论：tpe术后泌尿系统并发症较为常见。LARC和RRC的泌尿系统并发症发生率相似，放疗状况对该队列的预后没有影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Urology 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

9.50%

发文量

716

审稿时长

59 days

期刊介绍： Urology is a monthly, peer–reviewed journal primarily for urologists, residents, interns, nephrologists, and other specialists interested in urology The mission of Urology®, the "Gold Journal," is to provide practical, timely, and relevant clinical and basic science information to physicians and researchers practicing the art of urology worldwide. Urology® publishes original articles relating to adult and pediatric clinical urology as well as to clinical and basic science research. Topics in Urology® include pediatrics, surgical oncology, radiology, pathology, erectile dysfunction, infertility, incontinence, transplantation, endourology, andrology, female urology, reconstructive surgery, and medical oncology, as well as relevant basic science issues. Special features include rapid communication of important timely issues, surgeon''s workshops, interesting case reports, surgical techniques, clinical and basic science review articles, guest editorials, letters to the editor, book reviews, and historical articles in urology.