The Relationship Between Pelvic Autonomic Nerve Preservation and Postoperative Function in Surgery of Rectal Cancer_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

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顾晋

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Keywords：

直肠癌; 盆腔植物神经

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直肠癌是消化道最常见的恶性肿瘤之一，目前外科手术仍然是直肠癌最主要的治疗方法。随着淋巴结廓清范围的扩大，如侧方淋巴结的清扫、全直肠系膜切除术（TME)以及全盆脏器切除术的应用，进展期直肠癌的生存率已有明显改善。但另一方面，大范围的淋巴结清扫及全直肠系膜的完整切除已使许多患者的泌尿及生殖系统功能受到不同程度的影响。患者术后的生活质量是外科医师关注的主要问题，为此，许多外科医生进行了大量的研究工作，既确保根治性，又能最大限度地保留患者的排尿及性功能。近年来国内、外学者通过微创手术、TME结合保留盆腔自主神经（pelvic autonomic nerve preservation，PANP)的直肠癌手术逐渐开展，发现在行直肠癌根治手术时，有效地保留盆腔植物神经并没有明显增加局部复发率及降低5年生存率，取得了很好的效果［1～3］

Citation： 顾晋. The Relationship Between Pelvic Autonomic Nerve Preservation and Postoperative Function in Surgery of Rectal Cancer. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2003, 10(2): 98-99. doi: Copy

1.	Enker WE, Thaler HT, Cranor ML, et al. Total mesorectal excision in the operative treatment of carcinoma of the rectum [Ｊ]. J Am Coll Surg， 1995; 181(4)∶335.
2.	Mancini R, Cosimelli M, Filippini A, et al. Nervesparing surgery in rectal cancer: feasibility and functional results [Ｊ]. J Exp Clin Cancer Res, 2000; 19(1)∶35.
3.	Nesbakken A, Nygaard K, BullNjaa T, et al. Bladder and sexual dysfunction after mesorectal excision for rectal cancer [Ｊ]. Br J Surg， 2000; 87(2)∶206.
4.	Sugihara K, Moriya Y, Akasu T, et al. Pelvic autonomic nerve preservation for patients with rectal carcinoma. Oncologic and functional outcome [Ｊ]. Cancer, 1996; 78(9)∶1871.
5.	Broderick GA. Evidence based assessment of erectile dysfunction [Ｊ]. Int J Impot Res, 1998; 10(Suppl 2)∶S64.
6.	Davies MR. Anatomy of the nerve supply of the rectum, bladder, and internal genitalia in anorectal dysgenesis in the male [Ｊ]. J Pediatr Surg, 1997; 32(4)∶536.
7.	Havenga K, DeRuiter MC, Enker WE, et al. Anatomical basis of autonomic nervepreserving total mesorectal excision for rectal cancer [Ｊ]. Br J Surg, 1996; 83(3)∶384.
8.	Walsh PC, Schlegel PN. Radical pelvic surgery with preservation of sexual function [Ｊ]. Ann Surg， 1998; 208(4)∶391.
9.	Danzi M, Ferulan GP, Abate S, et al. Male sexual function after abdominoperineal resection for rectal cancer [Ｊ]. Dis Colon Rectum, 1983; 26(10)∶665.
10.	Cunsolo A, Bragaglia RB, Manara G, et al. Urogenital dysfunction after abdominoperineal resection for carcinoma of the rectum [Ｊ]. Dis Colon Rectum, 1990; 33(11)∶918.
11.	Havenga K, Enker WE, McDermott K, et al. Male and female sexual and urinary function after total mesorectal excision for autonomic nerve preservation for carcinoma of the rectum [Ｊ]. J Am Coll Surg, 1996; 192(6)∶495.
12.	Hojo K, Sawada T, Moriya Y. An analysis of survival and voiding, sexual function after wide iliopelvic lymphadenectomy in patients with carcinoma of the rectum, compared with conventional lymphadenectomy [Ｊ]. Dis Colon Rectum, 1989; 32(2)∶128.
13.	Hojo K, Vernava AM 3rd, Sugihara K, et al. Preservation of urine voiding and sexual function after rectal cancer surgery [Ｊ]. Dis Colon Rectum, 1991; 34(7)∶532.
14.	Kinn AC, Ohman U. Bladder and sexual function after surgery for rectal cancer [Ｊ].Dis Colon Retum, 1986; 29(1)∶43.
15.	Eickenberg HU, Amin M, Klompus W, et al. Urologic complications follwing abdominoperineal resection [Ｊ]. J Urol, 1976; 115(2)∶180.
16.	Maas CP, Moriya Y, Steup WH, et al. Radical and nervepreserving surgery for rectal cancer in the Netherlands: a prospective study on morbidity and functional outdy on morbidity and functional outcome[Ｊ]. Br J Surg, 1998; 85(1)∶92.
17.	Yasutomi M, Koh K. Functionpreserving operation in rectal cancer [Ｊ].Gan No Rinsho， 1986; 32(10)∶1322.
18.	Saito N, Koda K, Nobuhiro, et al. Nervesparing surgery for advanced rectal cancer patients: spectial reference to Dukes C patients [Ｊ]. World J Surg, 1999; 23(10)∶1062.
19.	Saito N, Sarashina H, Nunomura M, et al. Clinical evaluation of nervesparing surgery combined with preoperative radiotherapy in advanced rectal cancer patients [Ｊ].Am J Surg， 1998; 175(4)∶277.
20.	Masui H, Ike H, Yamaguchi S, et al. Male sexual function after autonomic. Nervepreserving operation for rectal cancer [Ｊ]. Dis Colon Rectum, 1996; 39(10)∶1140.
21.	Moriya Y, Sugihara K, Akasu T, et al. Patterns of recurrence after nervesparing surgery for rectal adenocarcinoma with special referenec to locoregional recurrence [Ｊ].Dis Colon Rectum， 1995; 38(11)∶1162.
22.	Enker WE. Potency, cure, and local control in the operative treatment of rectal cancer [Ｊ]. Arch Surg, 1992; 127(12)∶1396.
23.	Gerstenberg TC, Metz P, Ottesen B, et al. Intracavernous selfinjection with vasoactive intestinal polypeptide and phentolamine in the management of erectile failure [Ｊ]. J Urol, 1992; 147(5)∶1277.
24.	Furlow WL. Surgical management of impotence using the inflatable penile prosthesis: experience with 103 patients [Ｊ]. Br J Urol， 1978; 50(2)∶114.

1. Enker WE, Thaler HT, Cranor ML, et al. Total mesorectal excision in the operative treatment of carcinoma of the rectum [Ｊ]. J Am Coll Surg， 1995; 181(4)∶335.
2. Mancini R, Cosimelli M, Filippini A, et al. Nervesparing surgery in rectal cancer: feasibility and functional results [Ｊ]. J Exp Clin Cancer Res, 2000; 19(1)∶35.
3. Nesbakken A, Nygaard K, BullNjaa T, et al. Bladder and sexual dysfunction after mesorectal excision for rectal cancer [Ｊ]. Br J Surg， 2000; 87(2)∶206.
4. Sugihara K, Moriya Y, Akasu T, et al. Pelvic autonomic nerve preservation for patients with rectal carcinoma. Oncologic and functional outcome [Ｊ]. Cancer, 1996; 78(9)∶1871.
5. Broderick GA. Evidence based assessment of erectile dysfunction [Ｊ]. Int J Impot Res, 1998; 10(Suppl 2)∶S64.
6. Davies MR. Anatomy of the nerve supply of the rectum, bladder, and internal genitalia in anorectal dysgenesis in the male [Ｊ]. J Pediatr Surg, 1997; 32(4)∶536.
7. Havenga K, DeRuiter MC, Enker WE, et al. Anatomical basis of autonomic nervepreserving total mesorectal excision for rectal cancer [Ｊ]. Br J Surg, 1996; 83(3)∶384.
8. Walsh PC, Schlegel PN. Radical pelvic surgery with preservation of sexual function [Ｊ]. Ann Surg， 1998; 208(4)∶391.
9. Danzi M, Ferulan GP, Abate S, et al. Male sexual function after abdominoperineal resection for rectal cancer [Ｊ]. Dis Colon Rectum, 1983; 26(10)∶665.
10. Cunsolo A, Bragaglia RB, Manara G, et al. Urogenital dysfunction after abdominoperineal resection for carcinoma of the rectum [Ｊ]. Dis Colon Rectum, 1990; 33(11)∶918.
11. Havenga K, Enker WE, McDermott K, et al. Male and female sexual and urinary function after total mesorectal excision for autonomic nerve preservation for carcinoma of the rectum [Ｊ]. J Am Coll Surg, 1996; 192(6)∶495.
12. Hojo K, Sawada T, Moriya Y. An analysis of survival and voiding, sexual function after wide iliopelvic lymphadenectomy in patients with carcinoma of the rectum, compared with conventional lymphadenectomy [Ｊ]. Dis Colon Rectum, 1989; 32(2)∶128.
13. Hojo K, Vernava AM 3rd, Sugihara K, et al. Preservation of urine voiding and sexual function after rectal cancer surgery [Ｊ]. Dis Colon Rectum, 1991; 34(7)∶532.
14. Kinn AC, Ohman U. Bladder and sexual function after surgery for rectal cancer [Ｊ].Dis Colon Retum, 1986; 29(1)∶43.
15. Eickenberg HU, Amin M, Klompus W, et al. Urologic complications follwing abdominoperineal resection [Ｊ]. J Urol, 1976; 115(2)∶180.
16. Maas CP, Moriya Y, Steup WH, et al. Radical and nervepreserving surgery for rectal cancer in the Netherlands: a prospective study on morbidity and functional outdy on morbidity and functional outcome[Ｊ]. Br J Surg, 1998; 85(1)∶92.
17. Yasutomi M, Koh K. Functionpreserving operation in rectal cancer [Ｊ].Gan No Rinsho， 1986; 32(10)∶1322.
18. Saito N, Koda K, Nobuhiro, et al. Nervesparing surgery for advanced rectal cancer patients: spectial reference to Dukes C patients [Ｊ]. World J Surg, 1999; 23(10)∶1062.
19. Saito N, Sarashina H, Nunomura M, et al. Clinical evaluation of nervesparing surgery combined with preoperative radiotherapy in advanced rectal cancer patients [Ｊ].Am J Surg， 1998; 175(4)∶277.
20. Masui H, Ike H, Yamaguchi S, et al. Male sexual function after autonomic. Nervepreserving operation for rectal cancer [Ｊ]. Dis Colon Rectum, 1996; 39(10)∶1140.
21. Moriya Y, Sugihara K, Akasu T, et al. Patterns of recurrence after nervesparing surgery for rectal adenocarcinoma with special referenec to locoregional recurrence [Ｊ].Dis Colon Rectum， 1995; 38(11)∶1162.
22. Enker WE. Potency, cure, and local control in the operative treatment of rectal cancer [Ｊ]. Arch Surg, 1992; 127(12)∶1396.
23. Gerstenberg TC, Metz P, Ottesen B, et al. Intracavernous selfinjection with vasoactive intestinal polypeptide and phentolamine in the management of erectile failure [Ｊ]. J Urol, 1992; 147(5)∶1277.
24. Furlow WL. Surgical management of impotence using the inflatable penile prosthesis: experience with 103 patients [Ｊ]. Br J Urol， 1978; 50(2)∶114.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

The Relationship Between Pelvic Autonomic Nerve Preservation and Postoperative Function in Surgery of Rectal Cancer

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