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The risk factors for urinary dysfunction after autonomic nerve-preserving rectal cancer surgery: a multicenter retrospective study at Yokohama Clinical Oncology Group (YCOG1307)

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Aim

The aim of this retrospective study was to evaluate the frequency and risk factors of urinary dysfunction after autonomic nerve-preserving surgery for rectal cancer.

Methods

This was a retrospective multiinstitution study of 1002 rectal cancer patients conducted between January 2008 and December 2012 in Yokohama Clinical Oncology Group. Patients who had preoperative urinary dysfunction or had not undergone autonomic nerve preservation surgery were excluded. Urinary dysfunction was defined as that with a Clavien-Dindo classification grade ≥ 2. Patient-, tumor-, and surgery-related variables were examined by univariate and multivariate analyses.

Results

A total of 887 patients were analyzed. Postoperative urinary dysfunction was observed in 77 patients (8.8%). A multivariate logistic analysis showed that a tumor location in lower rectum (odds ratio [OR] 2.16; 95% confidence interval [CI] 1.15–3.71; p = 0.02), tumor diameter ≥ 40 mm (OR 2.07; 95% CI 1.19–4.44; p < 0.01), operation time ≥ 240 min (OR 2.07; 95% CI 1.19–4.44; p < 0.01), blood loss ≥ 300 ml (OR 2.35; 95% CI 1.12–3.84; p = 0.02), and diabetes (OR 3.26; 95% CI 1.80–5.89; p < 0.01) were independent risk factors of urinary dysfunction. The incidence of urinary dysfunction exceeded 20% in patients with 3 preoperative predictors (tumor location, tumor diameter, diabetes).

Conclusions

This result demonstrated that high-risk patients with more than two risk factors should be informed of the risk of urinary dysfunction.

Trial registration

UMIN000033688

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Acknowledgements

The authors thank all members of the institutions participating in the “YCOG 1307” project: Kazuteru Watanabe and Masashi Momiyama (NTT Medical Center Tokyo), Hidenobu Masui (Yokosuka Kyosai Hospital), Yasuhisa Mochizuki (Yokohama Municipal Citizen’s Hospital), Shigeru Yamagishi (Fujisawa Municipal Citizen’s Hospital), Tadao Fukushima (Saiseikai Yokohama Nanbu Hospital), Hitoshi Sekido (National Hospital Organization Yokohama Medical Center), Mitsutaka Sugita and Akira Watanabe (Yokohama City Minato Red Cross Hospital), Nobuyuki Kamimukai (Yokohama Hodogaya Central Hospital), Kunio Kameda (Yokosuka Municipal Citizen’s Hospital), Noriyuki Kamiya (Ito Municipal Hospital), and Daisuke Morioka (Yokohama Ekisaikai Hospital).

Author information

Authors and Affiliations

  1. Department of Surgery, Gastroenterological Center, Yokohama City University Medical Center, 4-57, Urafune-cho, Minami-ku, Yokohama, 232-0024, Japan

    Kenichiro Toritani, Jun Watanabe, Yusuke Suwa, Kazuya Nakagawa & Chikara Kunisaki

  2. Department of Gastroenterological Surgery, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Shinsuke Suzuki, Atsushi Ishibe, Mitsuyoshi Ota & Itaru Endo

  3. Department of Surgery, Yokosuka Kyosai Hospital, Yokosuka, Japan

    Hirokazu Suwa

Authors
  1. Kenichiro Toritani
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  2. Jun Watanabe
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  3. Yusuke Suwa
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  4. Shinsuke Suzuki
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  5. Kazuya Nakagawa
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  6. Hirokazu Suwa
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  7. Atsushi Ishibe
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  8. Mitsuyoshi Ota
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  9. Chikara Kunisaki
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  10. Itaru Endo
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Contributions

JW and MO contributed to the study design. All of the authors contributed to the data collection, data analysis, and interpretation. JW and KN contributed to the statistical analyses. All of the authors contributed to the writing or review of the report and approved the final version.

Corresponding author

Correspondence to Jun Watanabe.

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Conflict of interest

The authors declare that they have no conflict of interest.

Approval of the research protocol

The study protocol was approved by the Ethical Advisory Committee of Yokohama City University Graduate School of Medicine and the institutional review board of each participating hospital before the study was initiated.

Registry and the Registration No. of the Study: This study was registered with the Japanese Clinical Trials Registry as UMIN000033688 (http://www.umin.ac.jp/ctr/index.htm).

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Toritani, K., Watanabe, J., Suwa, Y. et al. The risk factors for urinary dysfunction after autonomic nerve-preserving rectal cancer surgery: a multicenter retrospective study at Yokohama Clinical Oncology Group (YCOG1307). Int J Colorectal Dis 34, 1697–1703 (2019). https://doi.org/10.1007/s00384-019-03374-3

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