Effect of autonomic nervous system resection extent on urinary dysfunction in robotic rectal cancer surgery

Abstract Aim We investigated whether autonomic nervous system resection during robotic rectal surgery contributes to urinary dysfunction and to what extent. Methods This retrospective cohort study included patients who underwent rectal surgery for primary rectal cancer between December 2011 and Apri...

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Main Authors: Sodai Arai, Hiroyasu Kagawa, Akio Shiomi, Yusuke Yamaoka, Shoichi Manabe, Chikara Maeda, Yusuke Tanaka, Shunsuke Kasai, Akifumi Notsu, Yusuke Kinugasa
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Annals of Gastroenterological Surgery
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Online Access:https://doi.org/10.1002/ags3.12878
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author Sodai Arai
Hiroyasu Kagawa
Akio Shiomi
Yusuke Yamaoka
Shoichi Manabe
Chikara Maeda
Yusuke Tanaka
Shunsuke Kasai
Akifumi Notsu
Yusuke Kinugasa
author_facet Sodai Arai
Hiroyasu Kagawa
Akio Shiomi
Yusuke Yamaoka
Shoichi Manabe
Chikara Maeda
Yusuke Tanaka
Shunsuke Kasai
Akifumi Notsu
Yusuke Kinugasa
author_sort Sodai Arai
collection DOAJ
description Abstract Aim We investigated whether autonomic nervous system resection during robotic rectal surgery contributes to urinary dysfunction and to what extent. Methods This retrospective cohort study included patients who underwent rectal surgery for primary rectal cancer between December 2011 and April 2021. We identified urinary dysfunction risk factors and examined the effect of autonomic nervous system resection extent on urinary dysfunction occurrence, with urinary dysfunction defined as a residual urine volume of >50 mL. Urinary dysfunction with no improvement over 1 y was defined as permanent urinary dysfunction. Results Of 1017 eligible patients, 78 (7.7%) required autonomic nervous system resection. Lateral lymph node dissection was performed in 357 patients (35.1%). Urinary dysfunction was observed in 102 patients (10.0%). We studied 32 (41.0%) of 78 patients who underwent autonomic nervous system resection and 82 (23.0%) of 357 patients who underwent lateral lymph node dissection presented with urinary dysfunction. Multivariate analysis revealed that lateral lymph node dissection and autonomic nervous system resection were significant predictors of urinary dysfunction. The urinary dysfunction incidence was notably higher in patients with autonomic nervous system unilateral total resection of at least one side than in those with bilateral preservation (65.4% vs. 28.8%, p < 0.01), and permanent urinary dysfunction exclusively occurred in these patients. Conclusion In robotic surgery, autonomic nervous system resection and lateral lymph node dissection were independent risk factors for urinary dysfunction. Furthermore, the extent of autonomic nervous system resection may increase the risk of permanent urinary dysfunction.
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spelling doaj-art-61eab90ca93c466ca89a4cea834c93c32025-08-20T03:10:08ZengWileyAnnals of Gastroenterological Surgery2475-03282025-05-019347648510.1002/ags3.12878Effect of autonomic nervous system resection extent on urinary dysfunction in robotic rectal cancer surgerySodai Arai0Hiroyasu Kagawa1Akio Shiomi2Yusuke Yamaoka3Shoichi Manabe4Chikara Maeda5Yusuke Tanaka6Shunsuke Kasai7Akifumi Notsu8Yusuke Kinugasa9Division of Colon and Rectal Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Colon and Rectal Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Colon and Rectal Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Colon and Rectal Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Colon and Rectal Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Colon and Rectal Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Colon and Rectal Surgery Shizuoka Cancer Center Shizuoka JapanDivision of Colon and Rectal Surgery Shizuoka Cancer Center Shizuoka JapanClinical Research Promotion Unit Shizuoka Cancer Center Shizuoka JapanDepartment of Gastrointestinal Surgery Institute of Science Tokyo Tokyo JapanAbstract Aim We investigated whether autonomic nervous system resection during robotic rectal surgery contributes to urinary dysfunction and to what extent. Methods This retrospective cohort study included patients who underwent rectal surgery for primary rectal cancer between December 2011 and April 2021. We identified urinary dysfunction risk factors and examined the effect of autonomic nervous system resection extent on urinary dysfunction occurrence, with urinary dysfunction defined as a residual urine volume of >50 mL. Urinary dysfunction with no improvement over 1 y was defined as permanent urinary dysfunction. Results Of 1017 eligible patients, 78 (7.7%) required autonomic nervous system resection. Lateral lymph node dissection was performed in 357 patients (35.1%). Urinary dysfunction was observed in 102 patients (10.0%). We studied 32 (41.0%) of 78 patients who underwent autonomic nervous system resection and 82 (23.0%) of 357 patients who underwent lateral lymph node dissection presented with urinary dysfunction. Multivariate analysis revealed that lateral lymph node dissection and autonomic nervous system resection were significant predictors of urinary dysfunction. The urinary dysfunction incidence was notably higher in patients with autonomic nervous system unilateral total resection of at least one side than in those with bilateral preservation (65.4% vs. 28.8%, p < 0.01), and permanent urinary dysfunction exclusively occurred in these patients. Conclusion In robotic surgery, autonomic nervous system resection and lateral lymph node dissection were independent risk factors for urinary dysfunction. Furthermore, the extent of autonomic nervous system resection may increase the risk of permanent urinary dysfunction.https://doi.org/10.1002/ags3.12878autonomic nervous systempelvic plexusrectal cancerrobotic surgeryurinary dysfunction
spellingShingle Sodai Arai
Hiroyasu Kagawa
Akio Shiomi
Yusuke Yamaoka
Shoichi Manabe
Chikara Maeda
Yusuke Tanaka
Shunsuke Kasai
Akifumi Notsu
Yusuke Kinugasa
Effect of autonomic nervous system resection extent on urinary dysfunction in robotic rectal cancer surgery
Annals of Gastroenterological Surgery
autonomic nervous system
pelvic plexus
rectal cancer
robotic surgery
urinary dysfunction
title Effect of autonomic nervous system resection extent on urinary dysfunction in robotic rectal cancer surgery
title_full Effect of autonomic nervous system resection extent on urinary dysfunction in robotic rectal cancer surgery
title_fullStr Effect of autonomic nervous system resection extent on urinary dysfunction in robotic rectal cancer surgery
title_full_unstemmed Effect of autonomic nervous system resection extent on urinary dysfunction in robotic rectal cancer surgery
title_short Effect of autonomic nervous system resection extent on urinary dysfunction in robotic rectal cancer surgery
title_sort effect of autonomic nervous system resection extent on urinary dysfunction in robotic rectal cancer surgery
topic autonomic nervous system
pelvic plexus
rectal cancer
robotic surgery
urinary dysfunction
url https://doi.org/10.1002/ags3.12878
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