Critical appraisal of management of rectal injury during radical prostatectomy

Urology
Wilmer B RobertsMisop Han

Abstract

To critically evaluate the perioperative management of rectal injury during radical prostatectomy. Rectal injuries were identified from the departmental morbidity and mortality records and radical prostatectomy databases. The electronic patient records were reviewed for management and outcomes. From January 1997 to August 2007, 11 452 men underwent radical prostatectomy. Of these men, 10 183 underwent radical retropubic prostatectomy (RRP) and 1269, laparoscopic retropubic prostatectomy (LRP) with or without robotic assistance. Rectal injury occurred in 18 men-12 in the RRP group (0.12%) and 6 in the LRP group (0.47%). Of these rectal injuries, 16 were recognized intraoperatively and primarily repaired in multiple layers without a diverting colostomy. A pedicle of omentum was used as an interposing layer in 4 of these cases. Despite primary repair, 2 patients without omental interposition developed a rectourethral fistula. In 1 man in the RRP group, the fistula closed with prolonged catheterization (9 weeks). In the other patient, in the LRP group, the fistula persisted; thus, a diverting colostomy was performed. Eventually, a transrectal advancement flap was required. Two rectal injuries (1 each in the RRP and LRP groups) were...Continue Reading

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Citations

Jul 2, 2011·Techniques in Coloproctology·L Chun, M A Abbas
Feb 9, 2013·Diseases of the Colon and Rectum·Elizabeth M HechenbleiknerElizabeth C Wick
Jun 16, 2012·Urology·Kazuhito MatsushitaJaspreet S Sandhu
Sep 29, 2011·Progrès en urologie : journal de l'Association française d'urologie et de la Société française d'urologie·E LacarriereC Pfister
Sep 20, 2015·European Urology·René J SoteloDavid Canes
Feb 22, 2012·BJU International·Anthony R Mundy, Daniela E Andrich
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Apr 15, 2016·Current Urology Reports·Joshua R KaplanAdam C Reese
Dec 4, 2014·Cirugía española·Carlos Cerdán Santacruz, Javier Cerdán Miguel
Jun 25, 2016·European Urology·Giulio NicitaAlberto Martini
Jul 12, 2017·International Urology and Nephrology·G MorettoM Inama

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