Evidence map›Paper›PMID 39716123›Full record

ArticleBMC surgery2024

Postoperative urinary dysfunction following lateral lymph node dissection for rectal cancer via minimally invasive surgery.

Makoto Takahashi, Kazuhiro Sakamoto, Hisashi Ro, Saki Kochi, Miyuki Toake, Hiromitsu Takahashi, Takahiro Irie, Hirotaka Momose, Kota Amemiya, Yuki Tsuchiya and 6 more

Abstract read
In one paragraph

Article in BMC surgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Makoto TakahashiDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan. mktakaha@juntendo.ac.jp.
Kazuhiro SakamotoDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Hisashi RoDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Saki KochiDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Miyuki ToakeDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Hiromitsu TakahashiDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Takahiro IrieDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Hirotaka MomoseDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Kota AmemiyaDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Yuki TsuchiyaDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Ryoichi TsukamotoDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Kumpei HonjoDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Masaya KawaiDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Shun IshiyamaDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Kiichi SugimotoDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.
Yutaka KojimaDepartment of Coloproctological Surgery, Juntendo University Faculty of Medicine, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLateral lymph node dissection (LLND) for locally advanced rectal cancer (LARC) is performed widely since it reduces local recurrence. However, there are some disadvantages to LLND, including technical difficulties and association with postoperative urinary dysfunction. Procedures for LARC have also become more minimally invasive: laparoscopic surgery (LS) has become more common, and use of robot-assisted LS (RALS) is increasing. The purpose of this study is to assess differences in postoperative urinary dysfunction after LLND for LARC between LS and RALS, and to identify risk factors for postoperative urinary dysfunction.

methodsThe subjects were 100 patients with LARC (≥ cT3) with the inferior border of the tumor reaching the peritoneal reflection who underwent LS or RALS with LLND between 2009 and 2023 at Juntendo University Hospital. After LLND, the urinary catheter was usually removed on or before postoperative day 5. The duration of urinary catheterization (DUC) was used to evaluate postoperative urinary dysfunction. The standard (S) and long-term (L) groups were defined as cases with urinary catheter removal at ≤ 5 and > 5 days, respectively. DUC was examined for LS vs. RALS and clinicopathological factors were identified that adversely affect DUC.

resultsOf the 100 subjects, 72 underwent LS and 28 received RALS. LLND was bilateral in 65 cases and unilateral in 35 cases. The median DUC was 5 days, with 74 cases in group S and 26 in group L. The most frequent postoperative complication (Clavien-Dindo Grade 2 or higher) was urinary dysfunction, followed by ileus and surgical site infection (SSI), and none differed by procedure (LS vs. RALS). Univariate analysis showed significant differences in LLND laterality (p = 0.02) and SSI (p = 0.04) between groups S and L. In multivariate analysis, bilateral LLND (p < 0.01, HR 7.37) and SSI (p = 0.01, HR 15.36) were independent factors that worsened DUC.

conclusionsThere was no difference in urinary dysfunction after LLND between LS and RALS. Bilateral LLND and SSI were risk factors for lengthening DUC. Compared to bilateral LLND, unilateral LLND can reduce urinary dysfunction; therefore, selective LLND, which is overwhelmingly unilateral LLND, and prevention of perioperative SSI may be important for maintenance of urinary function.

Indexed as

LaparoscopyLymph Node ExcisionPostoperative ComplicationsRectal NeoplasmsRobotic Surgical ProceduresAdultAgedAged, 80 and overFemaleHumansMaleMiddle AgedRetrospective StudiesRisk FactorsUrinary CatheterizationUrination DisordersDuration of urinary catheterizationLaparoscopic surgeryLateral lymph node resectionRectal cancerRemoval of urinary catheterRobot-assisted laparoscopic surgeryUrinary dysfunction

Identifiers

PMID39716123
PMCPMC11664852

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.