Key result
Laparoscopic radical prostatectomy was associated with rectal injury or rectourethral fistula in 1.7% of patients, which were successfully managed with primary closure or conservatively.
Why the study?
How are rectal injuries during laparoscopic radical prostatectomy detected and managed?
Observational (n=294)
How are rectal injuries during laparoscopic radical prostatectomy detected and managed?
Rectal injuries during laparoscopic radical prostatectomy can often be managed with primary closure without fecal diversion, and some postoperative fistulas may close spontaneously.
Rectal injuries in laparoscopic radical prostatectomy may be managed conservatively; this case report leaves open generalizability and need for prospective validation.
Among 294 patients who underwent laparoscopic radical prostatectomy (LRP), five (1.7%) developed complications such as rectal injury (RI) and rectourethral fistula (RUF). In four patients, the RI was immediately repaired by placing two layers of uninterrupted sutures without fecal diversion. The RI in two of these four patients were diagnosed using a transrectally inserted Hegar uterine dilator (26 mm). The remaining patients, who presented with RUF as the primary manifestation, were conservatively managed, and the fistulas closed spontaneously. Most of the RI detected during the operation were managed with primary fistula closure without fecal diversion. In some cases of postoperative RUF, spontaneous closure may occur while the patient is waiting for surgical repair.
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Masuda et al. (2010) conducted an observational in Prostate cancer (n=294). Laparoscopic radical prostatectomy was evaluated on Complications such as rectal injury (RI) and rectourethral fistula (RUF). Laparoscopic radical prostatectomy was associated with rectal injury or rectourethral fistula in 1.7% of patients, which were successfully managed with primary closure or conservatively.
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