Evaluation of the Results of Intraoperative Elimination of Rectal Wall Integrity Violation after Prostatectomy with the Formation of Fascial Duplication in Patients with Prostate Cancer: A Review of Clinical Practice in Two Russian Institutions

Introduction . An intraoperative complication of prostatectomy is injury to the rectal wall. Purpose of the work is to analyze the intraoperative management of rectal wall injuries occurring during prostatectomy. Materials and Methods. A study conducted involving 36 patients who sustained a rectal wall injury during prostatectomy, divided into two groups. Group I consisted of 30 patients in whom two-layer intestinal suture used. Group II consisted of 6 patients in whom an intestinal suture combined with a fascial duplicature. Results . Patients underwent prostatectomy with lymph node dissection. In Group I, 22 complications (73.3 %) classified Clavien-Dindo grade III were recorded, compared to 0 % in Group II. The use of a fascial duplicature in Group II increase operative time (p = 0.234) or blood loss (p = 0.340). There no significant difference in preoperative length of stay (p = 0.312), while total duration of hospitalization was half as long in Group II compared to Group I (p = 0.005). Following disease progression anticancer treatment required in 46.8 % (n = 14) of patients in Group I and 16.6 % (n = 1) of patients in Group II (p > 0.05). Follow-up, 20 men from Group I remained alive, while 8 deaths recorded. Causes of death malignant neoplasms (62.5 %) and cardiovascular diseases (37.5 %). Prostate cancer cause of death in 50.0 % (n = 4) deceased men. No deaths observed in group II. Conclusion . Fascial duplication demonstrated an absence of postoperative complications, with statistically significant reduction length of hospital stay and an improvement in both early and long-term outcomes.