自主神经系统切除程度对机器人直肠癌手术中泌尿功能障碍的影响

IF 2.9 4区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Sodai Arai, Hiroyasu Kagawa, Akio Shiomi, Yusuke Yamaoka, Shoichi Manabe, Chikara Maeda, Yusuke Tanaka, Shunsuke Kasai, Akifumi Notsu, Yusuke Kinugasa
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引用次数: 0

摘要

目的探讨机器人直肠手术中自主神经系统切除是否导致泌尿功能障碍,以及在多大程度上导致泌尿功能障碍。方法本回顾性队列研究纳入2011年12月至2021年4月期间因原发性直肠癌接受直肠手术的患者。我们确定了尿功能障碍的危险因素,并检查了自主神经系统切除程度对尿功能障碍发生的影响,将尿功能障碍定义为残余尿量为50 mL。1年以上无改善的尿功能障碍定义为永久性尿功能障碍。结果在1017例符合条件的患者中,78例(7.7%)需要自主神经系统切除术。357例(35.1%)患者行侧淋巴结清扫术。102例(10.0%)出现尿功能障碍。我们研究了78例自主神经系统切除术患者中的32例(41.0%)和357例侧淋巴结清扫患者中的82例(23.0%)出现尿功能障碍。多因素分析显示,侧淋巴结清扫和自主神经系统切除是泌尿功能障碍的重要预测因素。自主神经系统单侧全切除至少一侧患者的尿功能障碍发生率明显高于双侧全切除患者(65.4%比28.8%,p < 0.01),且永久性尿功能障碍仅发生在这些患者中。结论在机器人手术中,自主神经系统切除和外侧淋巴结清扫是泌尿功能障碍的独立危险因素。此外,自主神经系统切除的程度可能增加永久性尿功能障碍的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Effect of autonomic nervous system resection extent on urinary dysfunction in robotic rectal cancer surgery

Effect of autonomic nervous system resection extent on urinary dysfunction in robotic rectal cancer surgery

Aim

We investigated whether autonomic nervous system resection during robotic rectal surgery contributes to urinary dysfunction and to what extent.

Methods

This retrospective cohort study included patients who underwent rectal surgery for primary rectal cancer between December 2011 and April 2021. We identified urinary dysfunction risk factors and examined the effect of autonomic nervous system resection extent on urinary dysfunction occurrence, with urinary dysfunction defined as a residual urine volume of >50 mL. Urinary dysfunction with no improvement over 1 y was defined as permanent urinary dysfunction.

Results

Of 1017 eligible patients, 78 (7.7%) required autonomic nervous system resection. Lateral lymph node dissection was performed in 357 patients (35.1%). Urinary dysfunction was observed in 102 patients (10.0%). We studied 32 (41.0%) of 78 patients who underwent autonomic nervous system resection and 82 (23.0%) of 357 patients who underwent lateral lymph node dissection presented with urinary dysfunction. Multivariate analysis revealed that lateral lymph node dissection and autonomic nervous system resection were significant predictors of urinary dysfunction. The urinary dysfunction incidence was notably higher in patients with autonomic nervous system unilateral total resection of at least one side than in those with bilateral preservation (65.4% vs. 28.8%, p < 0.01), and permanent urinary dysfunction exclusively occurred in these patients.

Conclusion

In robotic surgery, autonomic nervous system resection and lateral lymph node dissection were independent risk factors for urinary dysfunction. Furthermore, the extent of autonomic nervous system resection may increase the risk of permanent urinary dysfunction.

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来源期刊
Annals of Gastroenterological Surgery
Annals of Gastroenterological Surgery GASTROENTEROLOGY & HEPATOLOGY-
CiteScore
5.30
自引率
11.10%
发文量
98
审稿时长
11 weeks
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