保留盆腔自主神经的全直肠系膜切除术在男性中、低位直肠癌中的应用
The application of total mesorectal excision with pelvic autonomic nerve preservation in middle or low rectal cancer in men
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摘要: 目的:探讨保留盆腔自主神经(PANP)的全直肠系膜切除术(TME)对男性直肠癌患者术后排尿功能、性功能及局部复发率的影响。方法:将71例男性中、低位直肠癌患者随机分成治疗组36例和对照组35例,对照组施行传统的直肠癌根治术,治疗组施行PANP-TME,比较2组术后排尿和性功能障碍的发生率及局部复发率。结果:治疗组与对照组排尿障碍发生率分别为16.7%和54.3%,勃起障碍发生率分别为30.6%和65.7%,射精障碍发生率分别为36.1%和71.4%,局部复发率分别为8.3%和11.4%;2组排尿功能及性功能障碍发生率差异均有统计学意义(P0.01),局部复发率差异无统计学意义(P0.05)。结论:PANP-TME不增加局部复发率,能有效降低男性患者术后排尿功能障碍和性功能障碍发生率。Abstract: ObjectiveTo evaluate the effects of total mesorectal excision( TME) with pelvic autonomic nerve preservation( PANP) in the treatment of rectal cancer on the male urinary and sexual function and local recurrence rate. Methods: Seventy-one male patients with middle or low rectal cancer were randomly divided into treatment group( 36 cases) and control group( 35 cases) .The treatment group and control group were treated with PANP-TME and traditional radical resection of rectal cancer, respectively.The incidences of male urinary disfunction, sexual dysfunction and tumor local recurrence in two groups were compared.Results: The incidences of urinary dysfunction, erectile dysfunction,defective ejaculation and tumor local recurrence in treatment group and control group were 16.7% &54.3%, 30.6% & 65.7%, 36.1%& 71.4% and 8.3% & 11.4%, respectively.The differences of the incidence of urinary and sexual dysfunction in two groups had statistical significance( P 0.01) , the difference of tumor local recurrence rate in two groups had no statistical significance ( P 0.05 ) . Conclusions: TME with PANP can effectively reduce the incidences of postoperative urinary dysfunction and sexual dysfunction,but it does not increase postoperative local recurence rate.
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