Retrospective risk analysis for acute urinary dysfunction after laparoscopic rectal cancer surgery in patients receiving epidural analgesia.

Hiraki, Masatsugu; Tanaka, Toshiya; Sadashima, Eiji; Sato, Hirofumi; Kitahara, Kenji

PURPOSE Urinary dysfunction (UD) is a frequent complication following rectal surgery. The aim of the present study was to investigate the risk factors for acute UD after laparoscopic low anterior resection (LALAR) for rectal cancer in patients receiving epidural analgesia. METHODS A retrospective study was conducted on 131 patients who underwent LALAR among those receiving epidural analgesia in a single institution between October 2008 and December 2019. Univariate and multivariate analyses were performed to determine the clinicopathological factors associated with acute UD. RESULTS The overall incidence of acute UD was 16.0% (21/131). Univariate analysis showed that older age (P = 0.016) and earlier urinary catheter removal (P = 0.036) were associated with acute UD. Multivariate logistic regression analysis revealed that older age (10-year increments; odds ratio (OR) 2.046, 95% confidence interval (CI) 1.171-3.543, P = 0.011), urinary catheter removal before epidural analgesia discontinuation (OR 6.393, 95% CI 1.540-26.534, P = 0.011), and a large tumor circumference rate (10% increments; OR 1.263, 95% CI 1.043-1.530, P = 0.017) were independent risk factors for acute UD. CONCLUSION Our findings suggest that older age, early removal of urinal catheter before epidural analgesia discontinuation, and large tumor circumference rate are risk factors of acute UD after LALAR for rectal cancer in patients receiving epidural analgesia.