The risk factors of acute urinary retention after laparoscopic colorectal cancer surgery in elderly patients receiving epidural analgesia.

ABSTRACT

PURPOSE: Urinary retention (UR) is a frequent complication following laparoscopic colorectal surgery. The aim of the present study was to investigate the risk factors for acute UR after laparoscopic surgery for colorectal cancer in patients receiving epidural analgesia. METHODS: A retrospective study was conducted of 201 patients who underwent laparoscopic surgery for colorectal cancer among those receiving epidural analgesia. Univariate and multivariate analyses were performed to determine the clinicopathological factors associated with acute UR. Acute UR was defined as Clavien-Dindo classification grade ≥ 1. RESULTS: The overall incidence of acute UR was 17.9% (36/201). The univariate analysis showed that male gender (P = 0.043), a history of chronic heart failure (P = 0.009), an increased level of serum creatinine (P = 0.028), an increased intraoperative fluid volume (P = 0.016), and an early postoperative date of urinary catheter removal (P = 0.003) were both associated with acute UR. The multivariate logistic regression analysis revealed an increased intraoperative fluid volume (100-ml increments; odds ratio [OR] 1.085, 95% confidence interval [CI] 1.034-1.138, P < 0.001), history of chronic heart failure (OR 6.843, 95% CI 1.893-24.739, P = 0.003), and postoperative date of urinary catheter removal (OR 0.550, 95% CI 0.343-0.880, P = 0.013) were independent risk factors for acute UR. CONCLUSION: Our findings suggest that an increased intraoperative fluid volume, history of chronic heart failure, and early removal of the urinary catheter are risk factors of UR after laparoscopic surgery for colorectal cancer in patients receiving epidural analgesia. An assessment using these factors might be helpful for predicting acute UR.