■经肛门全直肠系膜切除术已成为直肠癌患者腹腔镜全直肠系膜切除术中某些局限性的潜在解决方案。手术方式的差异引发了关于它们对术后尿潴留风险的影响的问题。从大规模随机临床研究中获得的数据有限。
■报告术后尿潴留的发生率,并评估经肛门全直肠系膜切除术的相关危险因素。
■在这项随机对照试验中(临床试验。govNCT06147492),我们检索到524例于2019年6月至2022年4月期间接受全直肠系膜切除术(TME)治疗I-III期直肠癌的患者,这些患者以1∶1的比例随机分组接受taTME或laTME治疗.
■我们在2019年6月至2022年4月期间纳入了524例接受I-III期直肠癌全直肠系膜切除术的患者。
■术后尿潴留的发生率。
■在524名登记的患者中,261人被随机分配到laTME组,其中263例随机分为taTME组。中位年龄为58岁,340名参与者(64.8%)为男性。值得注意的是,37例(7.0%)在随访期间出现术后尿潴留,taTME和laTME组之间没有观察到显著差异(6.8%和7.2%,分别,P=0.98)。taTME后患者与PUR相关的危险因素包括早期拔除导尿管(P=0.006),净输注速率>4.09mlkg-1。h-1(P=0.006),年龄超过65岁(P=0.0321)。
■在专科性直肠癌中心外发现的普遍性可能有限。
■经肛门全直肠系膜切除术未发现增加术后尿潴留的风险。尽管如此,建议在起始日之后拔除术后导管,并在临床实践中使用taTME操作时谨慎使用静脉输液.
UNASSIGNED: Transanal total mesorectal excision has emerged as a potential solution to certain limitations associated with laparoscopic total mesorectal excision in rectal cancer patients. Differences in surgical approaches have raised questions regarding their impact on the risk of postoperative urinary retention, with limited data available from large scale randomized clinical study.
UNASSIGNED: To report incidence of postoperative urinary retention and evaluate the associated risk factors for transanal total mesorectal excision.
UNASSIGNED: In this randomized controlled trial (ClinicalTrials. gov NCT06147492), we retrieved 524 patients who received total mesorectal excision (TME) for stage I-III rectal cancer between June 2019 and April 2022, and the patients were randomly assigned in a 1:1 ratio to undergo either taTME or laTME.
UNASSIGNED: We enrolled 524 patients who underwent total mesorectal excision for stage I-III rectal cancer between June 2019 and April 2022.
UNASSIGNED: The incidence of postoperative urinary retention.
UNASSIGNED: Among the 524 enrolled patients, 261 were randomized to the laTME group, while 263 were were randomized the taTME group. The median age was 58 years, and 340 participants (64.8 %) were male. Notably, 37 individuals (7.0 %) experienced postoperative urinary retention during the follow-up period, with no significant disparity was observed between the taTME and laTME groups (6.8 % and 7.2 %, respectively, P = 0.98). Risk factors associated with PUR in patients following taTME encompassed early removal of the urinary catheter (P = 0.006), net infusion rate >4.09 ml kg-1.h-1 (P = 0.006), and an age surpassing 65 years (P = 0.0321).
UNASSIGNED: The generalizability of the findings outside specialist rectal cancer centers may be limited.
UNASSIGNED: Transanal total mesorectal excision was not found to heighten the risk of postoperative urinary retention. Nonetheless, it is advisable removing postoperative catheter beyond the initial day and exercising caution in the administration of intravenous fluids in clinical practice for taTME procedures.