The Incidence of Genitourinary and Gastrointestinal Complications in Open and Endoscopic Gynecologic Cancer Surgery

Abstract

Objectives: The purpose of this study was to examine the incidence of genitourinary and intestinal tract injuries in an effort to identify which factors might predispose a patient to developing one of these surgical complications. Methods: We retrospectively evaluated the charts of gynecologic cancer patients who were treated at a single medical institution from January 2002 to February 2011. The following study variables were noted for evaluation: age, BMI, cancer origin, disease recurrence, a history of pelvic surgery, surgery type, operative approach and injury classification (genitourinary or gastrointestinal). Results: In our group of 1,618 patients, a total of 47 (2.9%) gastrointestinal and 18 (1.1%) genitourinary tract injuries were encountered. There were no intraoperative-related deaths but 2 patients expired 1 month after surgery. Logistic regression indicated that surgery type, undergoing an open procedure, cancerous involvement of the bowel or genitourinary tract and a history of pelvic surgery were significant predictors of operative injury occurrence [χ² (28) = 167.22; p < 0.001]. Conclusions: We ascertained a relatively lowincidence of gastrointestinal and genitourinary complications. Nevertheless, undergoing an open procedure, a history of pelvic surgery and surgical involvement of the bowel or genitourinary tract were predictive of an increased risk for these aforementioned injuries.

Endometriosis does not Increase Risk of Surgical Complications. A Comparative Study

“…It is stated that adhesions, previous surgery and endometriosis may increase the risk of bladder injury [13,14]. However, our data do not support this, since there was no significant difference between the two groups.…”

“…However, our data do not support this, since there was no significant difference between the two groups. Urinary tract injuries occurred equally in the two groups and the frequencies of 1,5% were comparable to the figures of 1,1% in a recent study of Rettenmaier et al [14] . Intestinal injury occurred in 6.5% of the patients with endometriosis and in 5.5% of the control patients.…”

“…Intestinal injury occurred in 6.5% of the patients with endometriosis and in 5.5% of the control patients. This is a higher percentage than found in the study of Rettenmaier et al [14]. The explanation for this may be that we classified minor damage to the serosa as an intestinal injury.…”

Outcomes of Iatrogenic Genitourinary Injuries During Colorectal Surgery

“…[1][2][3][4] In our study, we found the rate of all iatrogenic GU injuries occurring during colorectal surgeries to be only 0.18%. Slight variance of these rates within single-institution studies is to be expected, as many factors can alter the prevalence of iatrogenic injury.…”

“…The rates of total GU injuries during gynecologic surgery have been previously reported and range from 0.79-8.3%. 1 Most injuries involve the bladder. While the rate of total GU injuries is unknown for colorectal surgery, the rate of ureteral injuries specifically has been reported to be 0.24-5%.…”