Effect of Pelvic Autonomic Nerve Preservation with Total Mesorectal Excision on Sexual and Urinary Function in Male Rectal Cancer Patients_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHAO Feng , SHI Peiyou

Department of General Surgery, The First People’s Hospital of Huainan, Huainan 232007, Anhui Province, China;

Corresponding author：

Keywords：

Rectal cancer; Total mesorectal excision; Pelvic automatic nerve; Sexual function; Urinary function

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ObjectiveTo investigate the effect of pelvic autonomic nerve preservation (PANP) with total mesorectal excision (TME) on sexual and urinary function in male rectal cancer patients. MethodsClinical data of eightyfour patients with rectal cancer from January 2008 to October 2010 in our hospital were analyzed. According to different operative techniques, all the patients were divided into two groups: PANP+TME group (n=41) and TME group (n=43). The sexual dysfunction, urination disorder rate, and local recurrence rate after operation of patients between two groups were compared. ResultsErectile dysfunction rate of patients in TME+PANP group and TME group was 29.3% (12/41) and 76.7% (33/43), ejaculation disorder rate was 26.8% (11/41) and 79.1% (34/43), and urination dysfunction rate was 24.4% (10/41) and 79.1% (34/43), respectively. The rate of sexual and urinary dysfunction of patients in TME+PANP group was significantly lower than that in TME group (P lt;0.05). Local recurrence rate of patients in TME+PANP group (9.8%, 4/41) was similar to that in TME group (11.6%, 5/43)， P gt;0.05. ConclusionPANP based on TME can reduce effectively the rate of sexual and urinary dysfunction in male rectal cancer patients, which does not increase the local recurrence rate after operation.

Citation： ZHAO Feng,SHI Peiyou. Effect of Pelvic Autonomic Nerve Preservation with Total Mesorectal Excision on Sexual and Urinary Function in Male Rectal Cancer Patients. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2011, 18(2): 191-195. doi: Copy

1.	吴在德, 吴肇汉, 郑树, 等. 外科学 [M]. 第7版. 北京: 人民卫生出版社, 2008: 492496.
2.	吴阶平, 裘法祖, 吴蔚然, 等. 黄家驷外科学 [M]. 第6版. 北京: 人民卫生出版社, 2002: 11931201.
3.	李红光. 直肠癌局部转移规律与直肠癌术式的变革 [J]. 中国普外基础与临床杂志, 2003, 10(3): 303305.
4.	袁宝芳, 施雅兰, 帅敏. 直肠癌Miles手术后患者生活质量调查 [J]. 交通医学杂志, 2007, 21(6): 3133.
5.	汪建平, 杨祖立, 唐远志, 等. 直肠癌根治术中盆腔自主神经保留对男性性功能的影响 [J]. 中国实用外科杂志, 2003, 23(1): 4446.
6.	Havenga K, Enker WE, McDermott K, et al. Male and female sexual and urinary function after total mesorectal excision with autonomic nerve preservation for carcinoma of the rectum [J]. J Am Coll Surg, 1996, 182 (6): 495502.
7.	顾劲松, 于海滨, 赵明友. 直肠癌术中保留盆腔自主神经对男性排尿及性功能的影响 [J]. 局解手术学杂志, 2006, 11(1): 910.
8.	李立. 结直肠癌外科应用技术的规范与创新(一) [J]. 中国普外基础与临床杂志, 2006, 13(1): 106109.
9.	杨开焰, 陈道瑾, 李小荣, 等. 直肠癌肠系膜下动脉高位结扎对保留盆腔植物神经的临床研究 [J]. 中国现代医学杂志, 2010, 20(10): 15511553, 1556.
10.	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282.
11.	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539.
12.	顾晋, 马朝来, 夏家骝, 等. 直肠癌根治术中保留骨盆自主神经的神经解剖学基础及临床意义 [J]. 中华外科杂志, 2000, 38 (2): 128130.
13.	土屋周二. 直肠癌の手术,自律神经を温存する手术 [J]. 手术, 1983,12（3）: 13671370.
14.	杨映弘, 颜璟, 蔺原, 等. 腹腔镜全直肠系膜切除术盆腔自主神经保留对术后性功能的影响 [J]. 中国普外基础与临床杂志, 2008, 15(10): 726727.
15.	Maurer CA. Urinary and sexual function after total mesorectal excision [J]. Recent Results Cancer Res, 2005, 165: 196204.
16.	顾晋, 李学松. 保留盆腔自主神经的直肠癌手术对男性排尿及性功能的影响 [J]. 中华胃肠外科杂志, 2001, 4 (2): 126128.
17.	陈增蓉, 李卡, 印义琼. 低位直肠癌保肛手术中保留植物神经对患者排尿及性功能的影响 [J]. 中国循证医学杂志, 2006, 6(8): 571575.
18.	陈远光, 陈道瑾, 金钦文, 等. 直肠上动脉灌注美蓝指导全直肠系膜切除 [J]. 世界华人消化杂志, 2003, 11(1): 117119.
19.	Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery-the clue to pelvic recurrence? [J]. Br J Surg, 1982, 69(10): 613616.
20.	Pocard M, Zinzindohoue F, Haab F, et al. A prospective study of sexual and urinary function before and after total mesorectal excision with autonomic nerve preservation for rectal cancer [J]. Surgery, 2002, 131(4): 368372.
21.	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1880.
22.	刘荫华, 张寰, 高嵩, 等. 盆腔自主神经保留对直肠前切除术后排尿及性功能影响的观察 [J]. 中华普通外科杂志, 2003, 18(4): 222224.
23.	Ameda K, Kakizaki H, Koyanagi T, et al. The longterm voiding function and sexual function after pelvic nervesparing radical surgery for rectal cancer [J]. Int J Urol, 2005, 12(3): 256263.
24.	Havenga K, Enker WE. Autonomic nerve preserving total mesorectal excision [J]. Surg Clin North Am, 2002, 82 (5): 10091018.

1. 吴在德, 吴肇汉, 郑树, 等. 外科学 [M]. 第7版. 北京: 人民卫生出版社, 2008: 492496.
2. 吴阶平, 裘法祖, 吴蔚然, 等. 黄家驷外科学 [M]. 第6版. 北京: 人民卫生出版社, 2002: 11931201.
3. 李红光. 直肠癌局部转移规律与直肠癌术式的变革 [J]. 中国普外基础与临床杂志, 2003, 10(3): 303305.
4. 袁宝芳, 施雅兰, 帅敏. 直肠癌Miles手术后患者生活质量调查 [J]. 交通医学杂志, 2007, 21(6): 3133.
5. 汪建平, 杨祖立, 唐远志, 等. 直肠癌根治术中盆腔自主神经保留对男性性功能的影响 [J]. 中国实用外科杂志, 2003, 23(1): 4446.
6. Havenga K, Enker WE, McDermott K, et al. Male and female sexual and urinary function after total mesorectal excision with autonomic nerve preservation for carcinoma of the rectum [J]. J Am Coll Surg, 1996, 182 (6): 495502.
7. 顾劲松, 于海滨, 赵明友. 直肠癌术中保留盆腔自主神经对男性排尿及性功能的影响 [J]. 局解手术学杂志, 2006, 11(1): 910.
8. 李立. 结直肠癌外科应用技术的规范与创新(一) [J]. 中国普外基础与临床杂志, 2006, 13(1): 106109.
9. 杨开焰, 陈道瑾, 李小荣, 等. 直肠癌肠系膜下动脉高位结扎对保留盆腔植物神经的临床研究 [J]. 中国现代医学杂志, 2010, 20(10): 15511553, 1556.
10. 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282.
11. 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539.
12. 顾晋, 马朝来, 夏家骝, 等. 直肠癌根治术中保留骨盆自主神经的神经解剖学基础及临床意义 [J]. 中华外科杂志, 2000, 38 (2): 128130.
13. 土屋周二. 直肠癌の手术,自律神经を温存する手术 [J]. 手术, 1983,12（3）: 13671370.
14. 杨映弘, 颜璟, 蔺原, 等. 腹腔镜全直肠系膜切除术盆腔自主神经保留对术后性功能的影响 [J]. 中国普外基础与临床杂志, 2008, 15(10): 726727.
15. Maurer CA. Urinary and sexual function after total mesorectal excision [J]. Recent Results Cancer Res, 2005, 165: 196204.
16. 顾晋, 李学松. 保留盆腔自主神经的直肠癌手术对男性排尿及性功能的影响 [J]. 中华胃肠外科杂志, 2001, 4 (2): 126128.
17. 陈增蓉, 李卡, 印义琼. 低位直肠癌保肛手术中保留植物神经对患者排尿及性功能的影响 [J]. 中国循证医学杂志, 2006, 6(8): 571575.
18. 陈远光, 陈道瑾, 金钦文, 等. 直肠上动脉灌注美蓝指导全直肠系膜切除 [J]. 世界华人消化杂志, 2003, 11(1): 117119.
19. Heald RJ, Husband EM, Ryall RD. The mesorectum in rectal cancer surgery-the clue to pelvic recurrence? [J]. Br J Surg, 1982, 69(10): 613616.
20. Pocard M, Zinzindohoue F, Haab F, et al. A prospective study of sexual and urinary function before and after total mesorectal excision with autonomic nerve preservation for rectal cancer [J]. Surgery, 2002, 131(4): 368372.
21. 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1880.
22. 刘荫华, 张寰, 高嵩, 等. 盆腔自主神经保留对直肠前切除术后排尿及性功能影响的观察 [J]. 中华普通外科杂志, 2003, 18(4): 222224.
23. Ameda K, Kakizaki H, Koyanagi T, et al. The longterm voiding function and sexual function after pelvic nervesparing radical surgery for rectal cancer [J]. Int J Urol, 2005, 12(3): 256263.
24. Havenga K, Enker WE. Autonomic nerve preserving total mesorectal excision [J]. Surg Clin North Am, 2002, 82 (5): 10091018.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of Pelvic Autonomic Nerve Preservation with Total Mesorectal Excision on Sexual and Urinary Function in Male Rectal Cancer Patients

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