Prevalence of Urinary Tract Injuries in Patients With Rectal Cancer Undergoing Low Anterior Resection Versus Abdominal Abdominoperineal Resection at a Tertiary Care Center in Latin America

拉丁美洲一家三级医疗中心接受低位前切除术与腹会阴联合切除术的直肠癌患者泌尿系统损伤发生率

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Abstract

INTRODUCTION: Urinary tract injuries are uncommon complications in rectal cancer. However, there are no epidemiological data documenting their frequency in the patient population treated at the colorectal tumor service of the Oncology Hospital at CMN Siglo XIX. OBJECTIVE: The objective of this study is to compare and report the prevalence of urinary tract injuries in patients with rectal cancer undergoing low anterior resection (LAR) or abdominoperineal resection (APR) at a high-specialty center in Latin America. MATERIALS AND METHODS: An observational, retrospective, and cross-sectional study was conducted between 2017 and 2018. Patients with histopathologically confirmed diagnoses were included, and clinical and surgical variables were recorded, including the presence of a urinary tract injury. Statistical tests for normality, bivariate analysis, and likelihood ratios were applied, considering p < 0.05 as significant. RESULTS: Eight cases of urinary tract injuries were identified, corresponding to a prevalence of 5.2 percent, which is higher than that reported in international literature. No injury was recorded in 94.8 percent of cases. CONCLUSION: These findings suggest the need to improve intraoperative monitoring and prevention in such procedures. One of the ideal methods for ureteral identification that has recently gained popularity is indocyanine green, which is used to highlight ureteral anatomy and can serve as an alternative to methylene blue. The main advantage of this method is its accessibility, as it can be applied intraoperatively without significantly prolonging surgical time.

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