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Inicio Actas Urológicas Españolas (English Edition) Major urologic surgical procedures in locally advanced colorectal cancers
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Vol. 36. Issue 6.
Pages 361-366 (June 2012)
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Vol. 36. Issue 6.
Pages 361-366 (June 2012)
Original article
Major urologic surgical procedures in locally advanced colorectal cancers
Procedimientos quirúrgicos urológicos mayores en el cáncer colorrectal localmente avanzado
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995
C. Göktaş.a, R. Horuza,
Corresponding author
rahimhoruz@yahoo.com

Corresponding author.
, M. Yıldırımb, G. Faydacıa, C. Şahina, S. Albayraka
a Clínica de Urología, Hospital de Formación Kartal, Estambul, Turkey
b Clínica de Cirugía General, Hospital de Formación Kartal, Estambul, Turkey
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Tables (4)
Table 1. Diagnosis of the patients and main non-urologic surgical operations performed.
Table 2. Urologic surgical procedures, complications and histopathological findings.
Table 3. Data of the patients with finding of hydronephrosis.
Table 4. Data of the patients with hydronephrosis and elevated creatinine levels.
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Abstract
Objective

To evaluate the outcomes of major urological procedures performed in patients with locally advanced colorectal cancer.

Material and methods

Data of 37 patients with locally advanced colorectal cancer who underwent major urological surgical procedures along with simultaneous cancer surgery between the years of 2005 and 2010 were retrospectively evaluated.

Results

The mean age was 58.3 years. Male/female ratio was 2.7. 59% of the patients were primary, and 41% were recurrent cases of colorectal cancer. Bladder, ureters, urethra, kidneys and prostate were found as invaded in 19, 9, 5, 2 and 2 cases, respectively. The following single or combined procedures were performed; partial (n=11) or total (n=8; 2 combined with urethrocutaneostomy, 6 with ileal-conduit) cystectomy, urethroplasty (n=5), nephroureterectomy (n=2), radical nephrectomy (n=1), partial nephrectomy (n=1), ureteroneocystostomy (n=7), Boari's flap (n=4), transureteroureterostomy (n=3). Prolonged drainage was the most common surgical complication (27%). Urethrocutaneous fistula and total urinary incontinence were encountered in 1 and 1 patient, respectively. The incidence of hydronephrosis and elevated creatinine were 38% (preoperative 27%; postoperative 11%) and 24% (11% preoperative; 13% postoperative), respectively. Two deaths occurred in the first month of operations. Mean duration of follow up was 18(6–28) months for surviving 13 patients. Overall survival in 24 cases resulting in death was 21(1–42) months.

Conclusions

Since the most important eventual effects of locally advanced colorectal cancer are on the kidneys from the urological point of view; the aim of an urologist, as a member of surgical team, should be preserving renal function in addition to helping complete removal of the tumor.

Keywords:
Urologic surgical procedures
Colorectal cancer
Hydronephrosis
Kidney function
Urogenital system
Resumen
Objetivo

Evaluar los resultados de los principales procedimientos urológicos realizados en pacientes con cáncer colorrectal localmente avanzado.

Material y métodos

Los datos de 37 pacientes con cáncer colorrectal localmente avanzado, que se sometieron a los principales procedimientos quirúrgicos urológicos junto con la cirugía simultánea del cáncer entre los años 2005 y 2010, fueron evaluados retrospectivamente.

Resultados

La media de edad fue de 58,3 años. La proporción hombre/mujer fue de 2,7. El 59% de los pacientes eran casos primarios y el 41% eran casos recurrentes de cáncer colorrectal. La vejiga, los uréteres, la uretra, los riñones y la próstata se encontraron invadidos en 19, 9, 5, 2 y 2 casos, respectivamente. Se llevaron a cabo los siguientes procedimientos simples o combinados; cistectomía parcial (n=11) o total (n=8; 2 en combinación con uretrocutaneostomía, 6 con conducto ileal), uretroplastia (n=5), nefroureterectomía (n=2), nefrectomía radical (n=1), nefrectomía parcial (n=1), ureteroneocistostomía (n=7), colgajo de Boari (n=4), transureteroureterostomía (n=3). El drenaje prolongado fue la complicación quirúrgica más común (27%). Se encontraron fístula uretrocutánea e incontinencia urinaria total en cada una en un paciente, respectivamente. La incidencia de hidronefrosis y la elevación de la creatinina fueron del 38% (27% preoperatoria; 11% posoperatoria) y del 24% (11% preoperatoria; 13% posoperatoria), respectivamente. Dos muertes ocurrieron en el primer mes de operaciones. La duración media del seguimiento fue de 18 (6-28) meses para los 13 pacientes que sobrevivieron. La supervivencia global de 24 casos con resultado de muerte fue de 21 (1-42) meses.

Conclusiones

Dado que los efectos finales más importantes de cáncer colorrectal localmente avanzado se encuentran en los riñones desde el punto de vista urológico, el objetivo de un urólogo, como miembro del equipo quirúrgico, debe ser preservar la función renal además de ayudar a la eliminación completa del tumor.

Palabras clave:
Procedimientos quirúrgicos urológicos
Cáncer colorrectal
Hidronefrosis
Función renal
Sistema urogenital

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