Analysis of Survival and Functional Outcome after Nerve-Sparing Surgery with Extraperitoneal Lateral Lymphadenectomy for Lower Rectal Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZUO Ming , LIU Baoshan , XU Lin , YAN Jin , LIU Chao.

Department of General Surgery, Sichuan Cancer Hospital, Chengdu 610041, China;

Corresponding author：

Keywords：

Rectal carcinomaExtraperitoneal lymphadenectomyNerve-sparing surgery

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【Abstract】　Objective　To investigate the survival rate, voiding, sexual function after nerve-sparing surgery with extended systematic extraperitoneal lateral lymphadenectomy in lower rectal cancer. Methods　Three hundreds and ninety-two cases with advanced lower rectal cancer who underwent nerve-sparing surgery with radical dissection from 1996 to 2000 were reviewed. Among them,173 cases only cleared in abdominal cavity,219 cases coupled with extraperitoneal lateral lymphadenectomy. Results　The metastatic rate of lateral lymph node was 17.8%(39/219),the rate of non-modal foci of metastatic disease in lateral out of the abdominal cavity was 5.9%(13/219).Local recurrence rate, the abdominal cavity group was 16.2%（28/173）; the coupled group was 9.6%（21/219）， P＜0.05. Conclusion　By contrast,abdominal cavity coupled with extraperitoneal lympadenectomy acted to cut down local recurrence and to elevate 5-year survival rate,the postoperative quality of life with voiding, sexual function appeared to be seriously affected, although the radical dissection are nerve-sparing surgery.

Citation： ZUO Ming,LIU Baoshan,XU Lin,YAN Jin,LIU Chao.. Analysis of Survival and Functional Outcome after Nerve-Sparing Surgery with Extraperitoneal Lateral Lymphadenectomy for Lower Rectal Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2006, 13(5): 568-572. doi: Copy

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7.	Enker WE. Total mesorectal excision with sphincter and autonomic nerve preservation in the treatment of rectal cancer [J]. Curr Tech Gen Sury， 1996; 5（1)∶1.
8.	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.
9.	Kinn AC, Ohman U. Bladder and sexual function after surgery for rectal cancer [J]. Dis Colon Rectum, 1986; 29(1)∶43.
10.	Moriya Y, Sugihara K, Akasu T, et al. Nerve-sparing surgery with lateral node dissection for advanced lower rectal cancer [J]. Eur J Cancer, 1995; 31A(7-8)∶1229.
11.	森武生. 自律神經全溫存を伴う側方廓清 [J]. 消化器外科, 2000； 23(7)∶1253.
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.	Eickenberg HU, Amin M, Klompus W, et al. Urologic complications following abdominoperineal resection [J]. J Urol, 1976; 115(2)∶180.
14.	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 outcome [J]. Br J Surg, 1998; 85(1)∶92.
15.	Enker WE, Havenga K, Polyak T, et al. Abdominoperineal resection via total mesorectal excision and autonomic nerve preservation for low rectal cancer [J]. World J Surg, 1997; 21(7)∶715.
16.	小野正人. 下部直腸癌における側方廓清は標準的治療であるべきか [J]. 外科, 2000； 62（8）∶927.
17.	Takahashi T, Ueno M, Azekura K, et al. Lateral node dissection and total mesorectal excision for rectal cancer [J]. Dis Colon Rectum, 2000; 43(10 Suppl)∶S59.
18.	Moreira LF, Hizuta A, Iwagaki H, et al. Lateral lymph node dissection for rectal carcinoma below the peritoneal reflection [J]. Br J Surg, 1994; 81(2)∶293.

1. 　Stearns MW Jr, Deddish MR. Five-year results of abdominopelvic lymph node dissection for carcinoma of the rectum [J]. Dis Colon Rectum, 1959; 2(2)∶169.
2. 　高橋孝. 直腸癌根治術式の變遷と最新の話題 [J]. 消化器外科, 1998； 21（3）∶271.
3. 　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.
4. 　董新舒，李志高，崔滨滨，等. 低位直肠癌侧方淋巴结清扫的临床意义 [J]. 中国普外基础与临床杂志， 2003； 10（2)∶103.
5. 　加藤知行, 森武生. 直腸癌側方廓清の是非を間う [J]. 外科, 2000； 62（8）∶924.
6. 　森田隆幸, 中村文彥, 遠藤正章, 他. 腹膜外ァプローチに等る進行下部直腸癌のリンベ節廓清 [J]. 手術, 1995； 49（8）∶1065.
7. 　Enker WE. Total mesorectal excision with sphincter and autonomic nerve preservation in the treatment of rectal cancer [J]. Curr Tech Gen Sury， 1996; 5（1)∶1.
8. 　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.
9. 　Kinn AC, Ohman U. Bladder and sexual function after surgery for rectal cancer [J]. Dis Colon Rectum, 1986; 29(1)∶43.
10. 　Moriya Y, Sugihara K, Akasu T, et al. Nerve-sparing surgery with lateral node dissection for advanced lower rectal cancer [J]. Eur J Cancer, 1995; 31A(7-8)∶1229.
11. 　森武生. 自律神經全溫存を伴う側方廓清 [J]. 消化器外科, 2000； 23(7)∶1253.
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. 　Eickenberg HU, Amin M, Klompus W, et al. Urologic complications following abdominoperineal resection [J]. J Urol, 1976; 115(2)∶180.
14. 　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 outcome [J]. Br J Surg, 1998; 85(1)∶92.
15. 　Enker WE, Havenga K, Polyak T, et al. Abdominoperineal resection via total mesorectal excision and autonomic nerve preservation for low rectal cancer [J]. World J Surg, 1997; 21(7)∶715.
16. 　小野正人. 下部直腸癌における側方廓清は標準的治療であるべきか [J]. 外科, 2000； 62（8）∶927.
17. 　Takahashi T, Ueno M, Azekura K, et al. Lateral node dissection and total mesorectal excision for rectal cancer [J]. Dis Colon Rectum, 2000; 43(10 Suppl)∶S59.
18. 　Moreira LF, Hizuta A, Iwagaki H, et al. Lateral lymph node dissection for rectal carcinoma below the peritoneal reflection [J]. Br J Surg, 1994; 81(2)∶293.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Analysis of Survival and Functional Outcome after Nerve-Sparing Surgery with Extraperitoneal Lateral Lymphadenectomy for Lower Rectal Carcinoma

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