# Prevalence of Urinary Tract Injuries in Patients With Rectal Cancer Undergoing Low Anterior Resection Versus Abdominal Abdominoperineal Resection at a Tertiary Care Center in Latin America

## TL;DR

This study finds a higher-than-expected rate of urinary tract injuries in rectal cancer surgeries in Latin America and suggests using indocyanine green to prevent such injuries.

## Contribution

The study reports a novel prevalence rate of urinary tract injuries in rectal cancer surgeries in a Latin American center and proposes indocyanine green as a practical prevention method.

## Key findings

- Eight cases of urinary tract injuries were found, with a 5.2% prevalence.
- No injuries were recorded in 94.8% of the cases.
- Indocyanine green is suggested as an accessible intraoperative tool for ureteral identification.

## Abstract

Introduction: Urinary tract injuries are uncommon complications in rectal cancer. However, there are no epidemiological data documenting their frequency in the patient population treated at the colorectal tumor service of the Oncology Hospital at CMN Siglo XIX.

Objective: The objective of this study is to compare and report the prevalence of urinary tract injuries in patients with rectal cancer undergoing low anterior resection (LAR) or abdominoperineal resection (APR) at a high-specialty center in Latin America.

Materials and methods: An observational, retrospective, and cross-sectional study was conducted between 2017 and 2018. Patients with histopathologically confirmed diagnoses were included, and clinical and surgical variables were recorded, including the presence of a urinary tract injury. Statistical tests for normality, bivariate analysis, and likelihood ratios were applied, considering p < 0.05 as significant.

Results: Eight cases of urinary tract injuries were identified, corresponding to a prevalence of 5.2 percent, which is higher than that reported in international literature. No injury was recorded in 94.8 percent of cases.

Conclusion: These findings suggest the need to improve intraoperative monitoring and prevention in such procedures. One of the ideal methods for ureteral identification that has recently gained popularity is indocyanine green, which is used to highlight ureteral anatomy and can serve as an alternative to methylene blue. The main advantage of this method is its accessibility, as it can be applied intraoperatively without significantly prolonging surgical time.