Analysis of a Surgical Treatment for Persistent Urorectal Fistulas after Radical Cancer Surgery: A Comparison of Prostate Cancer and Rectal Cancer

Sakai, Yasuyuki; Komai, Yoshinobu; Saitô, Norio; Ito, Masaaki; Sakuraba, Minoru

doi:10.1159/000457835

Cited by 3 publications

(1 citation statement)

References 14 publications

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“…These findings may obviate an attempt to repair and serve as a guide for a permanent diversion strategy (10). It is well recognized that the success rate in repairing a complex fistula with radiation and/or ablative energy source is much lower than a fistula after surgery alone (4,11,12).…”

Section: Introductionmentioning

confidence: 99%

Urorectal fistula repair using different approaches: operative results and quality of life issues

et al. 2021

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Purpose: To evaluate efficacy of urorectal fistula (URF) repair using different approaches and the clinical factor determinant of success, and also the morbidity associated to the procedure and health-related quality of life (HRQoL) in male survivors of pelvic malignancies. Material and Methods: Retrospective evaluation of 39 patients with URF primarily intervened in three institutions using different surgical approaches. Success was defined as effective fistula closure. Variables evaluated included demographics, previous treatments, surgical approach, ancillary surgeries, complications and HRQoL by using a standardized nonvalidated specific questionnaire. Median follow-up from surgery to interview was 55 months (interquartile range 49, range 4-112). Factors determinant of success were investigated using logistic regression. Safety of the procedure was evaluated by Clavien-Dindo scale. Deterioration of continence and erectile function and other HRQoL issues were evaluated. Results: Prostate cancer treatment was the predominant etiology. The success rate for fistula repair was 89.5%. The surgical approach was not related to failed repair (p=0.35) or complications (p=0.29). Factors associated with failure were complications (p=0.025), radiotherapy (p=0.03), fistula location (p=0.04) and fistula size (p=0.007). Multivariate analysis revealed fistula size was the only independent determinant of failure (OR 6.904, 1.01-47.75). Complications occurred in 46.2% and severe complications in 12.8%. The mortality related to the procedure was 2.6%. Urinary incontinence was present before repair in 26.3% and erectile dysfunction in 89.5%. Fistula repair caused de novo urinary incontinence in 7.9% and deterioration of erectile status in 44.7%. Globally 79% were satisfied after repair and only 7.9% rated HRQoL as unhappy. Trans-sphincteric approach was related to less deterioration of erectile function (p=0.003), and higher perceived satisfaction in QoL (p=0.04). Conclusions: The surgical approach elected to correct URF is not determinant of success nor of complications. Fistula size appears as independent determinant for failure. Transsphincteric approach could be advantageous over other procedures regarding HRQoL issues.

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Section: Introductionmentioning

confidence: 99%

Urorectal fistula repair using different approaches: operative results and quality of life issues

et al. 2021

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Surgical outcome for colorectal or urinary tract-related fistula: Usefulness of vascularized tissue transfer—a retrospective study⁎

Higashino

Sakuraba

Fukunaga

et al. 2021

Journal of Plastic, Reconstructive & Aesthetic Surgery

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BUB1B Promotes Proliferation of Prostate Cancer via Transcriptional Regulation of MELK

Tian

Zeng

et al. 2020

ACAMC

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Background: Prostate cancer remains one of both the most common and deadliest forms of cancer, which is still localized generally respond well to radical prostatectomy and associated interventions, up to 30% of these individuals will still suffer from disease relapse. BUB1B has been found to be essential for cell growth and proliferation, even in several kinds of tumor cells. But the specific importance and mechanistic role of BUB1B in prostate cancer remains unclear. Methods: Quantitative Real-Time PCR and Western-blot were used in detection of mRNA and protein expression. Lentivirus infection was used to overexpression or knock down target gene. Flow cytometry analysis was performed to test protein expression and apoptosis level. Immunohistochemistry was used to identify protein expression in tissue. Statistical differences between two groups are evaluated by two-tailed t-tests. The comparison among multiple groups is performed by one-way Analysis of Variance (ANOVA) followed by Dunnett’s posttest. The statistical significance of the Kaplan-Meier survival plot is determined by log-rank analysis. Results: In the present report, we found BUB1B expression to be highly increased in prostate cancer tissues relative to normal controls. We further found BUB1B to be essential for efficient tumor cell proliferation, and to correlate with poorer prostate cancer patient outcomes. From a mechanistic perspective, the ability of BUB1B to regulate MELK was found to be essential for its ability to promote prostate cancer cell proliferation. Conclusion: Altogether, our data suggests that BUB1B is up-regulated in prostate cancer, suggesting that growth of cancer cells may depend on BUB1B-dependent regulation of MELK transcription. BUB1B may serve as a clinical prognostic factor and a druggable target for prostate cancer.

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Analysis of a Surgical Treatment for Persistent Urorectal Fistulas after Radical Cancer Surgery: A Comparison of Prostate Cancer and Rectal Cancer

Cited by 3 publications

References 14 publications

Urorectal fistula repair using different approaches: operative results and quality of life issues

Urorectal fistula repair using different approaches: operative results and quality of life issues

Surgical outcome for colorectal or urinary tract-related fistula: Usefulness of vascularized tissue transfer—a retrospective study⁎

BUB1B Promotes Proliferation of Prostate Cancer via Transcriptional Regulation of MELK

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