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Incidence and Clinical Outcomes of Gonadal Artery Injury during Colorectal Surgery in Male Patients

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Journal of Gastrointestinal Surgery

Abstract

Background

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.

Methods

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.

Results

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).

Conclusions

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.

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References

  1. Bothwell, W.N., R.J. Bleicher, and T.L. Dent, Prophylactic ureteral catheterization in colon surgery. A five-year review. Dis Colon Rectum, 1994. 37(4): p. 330-4.

    Article  CAS  Google Scholar 

  2. Kyzer, S. and P.H. Gordon, The prophylactic use of ureteral catheters during colorectal operations. Am Surg, 1994. 60(3): p. 212-6.

    CAS  PubMed  Google Scholar 

  3. Delacroix, S.E., Jr. and J.C. Winters, Urinary tract injures: recognition and management. Clin Colon Rectal Surg, 2010. 23(2): p. 104-12.

    Article  Google Scholar 

  4. Chan, P.T., E.J. Wright, and M. Goldstein, Incidence and postoperative outcomes of accidental ligation of the testicular artery during microsurgical varicocelectomy. J Urol, 2005. 173(2): p. 482-4.

    Article  Google Scholar 

  5. Cuda, S.P., et al., Incidence and clinical significance of arterial injury in varicocele repair. BJU Int, 2011. 107(10): p. 1635-7.

    Article  Google Scholar 

  6. Yamamoto, M., et al., Comparison of artery-ligating and artery-preserving varicocelectomy: effect on post-operative spermatogenesis. Andrologia, 1995. 27(1): p. 37-40.

    Article  CAS  Google Scholar 

  7. Matsuda, T., Y. Horii, and O. Yoshida, Should the testicular artery be preserved at varicocelectomy? J Urol, 1993. 149(5 Pt 2): p. 1357-60.

    Article  CAS  Google Scholar 

  8. Yu, W., et al., Laparoscopic Varicocelectomy in Adolescents: Artery Ligation and Artery Preservation. Urology, 2016. 89: p. 150-4.

    Article  Google Scholar 

  9. Global Health Observatory (GHO) data of Body Mass Index. World Health Organization, 2018.

  10. Althumairi, A.A. and J.E. Efron, Genitourinary Considerations in Reoperative and Complex Colorectal Surgery. Clin Colon Rectal Surg, 2016. 29(2): p. 145-51.

    Article  Google Scholar 

  11. Halabi, W.J., et al., Ureteral injuries in colorectal surgery: an analysis of trends, outcomes, and risk factors over a 10-year period in the United States. Dis Colon Rectum, 2014. 57(2): p. 179-86.

    Article  Google Scholar 

  12. Andersen, P., L.M. Andersen, and L.H. Iversen, Iatrogenic ureteral injury in colorectal cancer surgery: a nationwide study comparing laparoscopic and open approaches. Surg Endosc, 2015. 29(6): p. 1406-12.

    Article  Google Scholar 

  13. Rose, J., et al., Complications in laparoscopic colorectal surgery: results of a multicentre trial. Tech Coloproctol, 2004. 8 Suppl 1: p. s25-8.

    Article  Google Scholar 

  14. Alizadeh, R.F., et al., Body Mass Index Significantly Impacts Outcomes of Colorectal Surgery. Am Surg, 2016. 82(10): p. 930-935.

    PubMed  Google Scholar 

  15. Lamba, R., et al., CT Hounsfield Numbers of Soft Tissues on Unenhanced Abdominal CT Scans: Variability Between Two Different Manufacturers’ MDCT Scanners. AJR. American journal of roentgenology, 2014. 203(5): p. 1013-1020.

    Article  Google Scholar 

  16. Zollinger, R.M., Testicular Atrophy, in Abdominal Wall Hernias: Principles and Management, R. Bendavid, et al., Editors. 2001, Springer New York: New York. p. 179-183.

    Chapter  Google Scholar 

  17. Kayalvizhi, I., R.K. Narayan, and P. Kumar, Anatomical variations of testicular artery: a review. Folia Morphol (Warsz), 2017.

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Acknowledgments

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.

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Authors and Affiliations

  1. Division of Colorectal Surgery, Department of Surgery, Kaohsiung Veteran General Hospital, 386 Ta-Chung 1st RD, Kaohsiung, Taiwan, 81346, Republic of China

    Chao-Wen Hsu, Min-Chi Chang, Jui-Ho Wang, Chih-Chien Wu & Yu-Hsun Chen

  2. Faculty of Medicine, National Yang-Ming University, Taipei City, Taiwan

    Chao-Wen Hsu

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  1. Chao-Wen Hsu
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  2. Min-Chi Chang
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Contributions

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.

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Correspondence to Chao-Wen Hsu.

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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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Hsu, CW., Chang, MC., Wang, JH. et al. Incidence and Clinical Outcomes of Gonadal Artery Injury during Colorectal Surgery in Male Patients. J Gastrointest Surg 23, 2075–2080 (2019). https://doi.org/10.1007/s11605-019-04197-x

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  • DOI: https://doi.org/10.1007/s11605-019-04197-x

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