Incidence and Clinical Outcomes of Gonadal Artery Injury during Colorectal Surgery in Male Patients
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Gonadal artery is susceptible to accidental injury due to their anatomical proximity to the colon and rectum. There are few literature reviews focusing on this injury during colorectal surgery. We conduct a retrospective study to evaluate the incidence and the clinical significance of these injuries in terms of testicular size and testicular enhancement on the contrast CT scan.
Patients’ characteristic data included age, body mass index (BMI), diagnosis, operation type, cause of gonadal artery injury, side of injury, level of injury, method of vessel ligation, and follow-up period. We measured the testicular sizes before and after gonadal artery injury and measured the enhancement level by recording the mean attenuation value on the injury side and non-injury side of the testis on the CT scan.
The incidence of gonadal artery injury was 3.61% and 15 male patients with this injury were enrolled. There were 5 patients with iatrogenic injury and 10 patients with non-iatrogenic injury due to advanced tumor or inflammation. No patients had any complaints of testicular discomforts or atrophy after the surgery. The testicular sizes before and after the surgery showed no significant difference (p = 0.877). The mean attenuation values of the injury side and non-injury side of the testis also showed no significant difference (p = 0.79).
Gonadal artery injury during colorectal surgery is not a rare complication. To prevent this injury, knowledge of the anatomy and staying in the proper plane of dissection are the key points. In patients with gonadal artery injury during colorectal surgery, sacrifice of the gonadal artery is safe without clinical significance in terms of testicular size and testicular enhancement on the contrast CT scan.
KeywordsGonadal artery Colorectal Male
This work was supported by the Kaohsiung Veterans General Hospital, Taiwan (grant KSB108-056). This work was assisted in part by the Division of Colorectal Surgery of the Department of Surgery, Kaohsiung Veterans General Hospital.
Chao-Wen Hsu: study concept and design; acquisition of data; analysis and interpretation of data; drafting of the manuscript; statistical analysis. Min-Chi Chang, Chih-Chien Wu, Yu-Hsun Chen: acquisition of data. Jui-Ho Wang: critical revision of the manuscript for import ant intellectual content.
Compliance with Ethical Standards
Disclosures Chao-Wen Hsu MD, Min-Chi Chang MD, Jui-Ho Wang MD,
Chih-Chien Wu MD, Yu-Hsun Chen MD declare that they have no conflict of interest.
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