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Publications

Journal Article Ahead of print

PubMed: 42246495 DOI: 10.1080/00015458.2026.2682162

Risk factors associated with urinary tract infection within 4 days of male rectal cancer surgery in the era of enhanced recovery after surgery (ERAS) programs.

Acta Chir Belg

Authors: Jean-Luc Faucheron, Fatah Tidadini, Zaher Lakkis, Mehrdad Jafari, Adeline Germain, Eric Rullier, Jérémie Lefevre, Jean-Jacques Tuech, Alex Kartheuser, Daniel Leonard, Michel Prudhomme, Guillaume Piessen, Jean-Marc Regimbeau, Eddy Cotte, Damien Duprez, Bogdan Badic, Yves Panis, Michel Rivoire, Bernard Meunier, Guillaume Portier, Jean-Luc Bosson, Antoine Vilotitch, Alison Foote, Juliette Fischer, Yvan Caspar, Philippe Rouanet, Bertrand Trilling

Affiliations

  • Colorectal Unit, Department of Surgery, Grenoble Alpes University Hospital, F-38000 Grenoble, France.
  • TIMC-IMAG - CNRS UMR 5525, University Grenoble Alpes, F-38000 Grenoble, France.
  • Lyon Center for lnnovation in Cancer, EA 3738, Lyon 1 University, Lyon, France.
  • Department of Surgical Oncology, Besancon University Hospital, Besancon, France.
  • Department of Digestive and Oncological Surgery, Oscar Lambret Center, Lille, France.
  • Digestive Surgery Department, University Hospital of Nancy, Nancy, France.
  • Digestive Surgery Department, Bordeaux University Hospital, Bordeaux, France.
  • Digestive Surgery Department, Saint-Antoine Hospital, APHP, Paris, France.
  • Digestive Surgery Department, Rouen University Hospital, Rouen, France.
  • Department of Medical Oncology, Clinique universitaire Saint Luc, Brussels, Belgium.
  • Department of Digestive Surgery, Nîmes, University Hospital, Nîmes, France.
  • Digestive Surgery Department, University Hospital of Lille, Lille, France.
  • Department of Digestive Surgery, Amiens University Hospital, Amiens, France.
  • Digestive Surgery Department, Lyon-Sud University Hospital, Pierre-Bénite, France.
  • Digestive Surgery Department, Annecy-Genevois Hospital, Metz-Tessy, France.
  • Department of General and Digestive Surgery, Brest, University Hospital, Brest, France.
  • Department of Colorectal Surgery, Beaujon Hospital, AP-HP, Clichy, France.
  • Department of Surgical Oncology, Léon Bérard Center, Lyon, France.
  • Department of Hepatobiliary and Digestive Surgery, Rennes University Hospital, Rennes, France.
  • Department of Digestive Surgery, Toulouse Purpan University Hospital, Toulouse France.
  • Department of Medical Information, Grenoble-Alpes University Hospital, Grenoble, France.
  • Laboratory of Bacteriology, Grenoble-Alpes University Hospital, Grenoble, France.
  • Surgical Oncology Department, Montpellier Cancer Institute (ICM), Montpellier, France.

Abstract

BACKGROUND

Bladder drainage is systematically used in rectal cancer surgery in male patients, even in the era of enhanced recovery after surgery (ERAS). However, little data is available on risk factors for urinary tract infection (UTI). Identifying the risk factors associated with UTI within 4 days of male rectal cancer surgery in an ERAS program could support more individualized decision-making.

METHODS

We used data from the GRECCAR 10 randomized clinical trial, a comparison of outcomes of transurethral catheterization (TUC) or suprapubic catheterization (SPC). 240 patients were randomized, 209 retained in the study (TUC n = 99; SPC n = 109). Univariate and multivariate logistic regression post-hoc study analyses were performed to assess association between potential predictive factors and UTI within 30 days after surgery.

RESULTS

Out of 208 patients (median age 64.5 years), 19 (9.1%) had UTI, 26 (12.5%) had bacteriuria and 145 (69.7%) had pyuria. Univariate analysis identified age ≥ 65 years (OR = 3.08 [1.07-8.89]; p = 0.038), hypertension (OR = 3.65 [1.23-10.84]; p = 0.020) and ASA score ≥ 3 (OR = 4.15 [1.53-11.2]; p = 0.005) as risk factors for UTI until POD4. Multivariate analysis identified ASA score ≥ 3 with a risk of UTI.

CONCLUSION

Regarding male rectal cancer surgery, our study shows that nearly 1 in 10 patients had UTI within 4 days. An ASA score ≥ 3 is an independent risk factor linked to UTI. Identifying this risk factor for UTI is necessary to advise patients, support a tailored decision-making process, and prevent these complications.

MeSH

Urinary Tract, Neoplasms, Recycling, Urinary Tract Infections, Rectal Neoplasms, Risk Factors, Enhanced Recovery After Surgery, General Surgery, Catheterization, Infections