女性直肠癌根治术中保留盆腔自主神经120例分析

Pelvic autonomic nerve preservation in 96 female patients of rectal carcinoma undergoing radical resection

目的探讨盆腔自主神经保留对改善女性直肠癌根治术后性功能和排尿功能的价值。方法回顾性分析120例女性中下段直肠癌病例盆腔自主神经保留组和非盆腔自主神经保留组的性功能障碍和排尿功能障碍的发生率。差异采用χ2检验。结果两组患者术后性欲下降、性高潮减退、阴道湿润度减退和性交时疼痛的发生率分别为12.5%、10.5%、8.33%、4.15%和54.1%、45.9%、41.7%、37.5%,差异有统计学意义(P<0.01);后盆腔清除术研究组和对照组术后性功能障碍的发生率分别为58.33%和66.67%,两组比较差异无统计学意义(P>0.05)。结论盆腔自主神经保留可明显改善女性直肠癌手术后性功能和排尿功能;但是后盆清除术时保留自主神经效果并不显著。

Objective To evaluate the effect on postoperative urinary and sexual function of radical resection with pelvic autonomic nerve preservation for female rectal cancer patients. Methods Postoperative sex and urination disorders were compared between groups of pelvic autonomic nerve preservation and conventional procedure in 120 female cases of middle-lower rectal carcinoma undergoing radical resection. Results The venery decline,sexual climax slip,vagina wetness degree slip and the coition pain rate were 12. 5% , 10.5% ,8. 33% ,4. 15% in autonomic nerve preservation group and 54. 1% ,45.9% ,41.7% ,37.5% in control group, respectively（ all P 〈0. 01 ） ;No significant difference was found in the sexual disorders between the two groups in case of posterior pelvic exenteration （58. 33% vs. 66. 67%, P 〉 0. 05 ）. Conclusion Pelvic autonomic nerve preservation is effective to reduce postoperative sex and urination disorders in female rectal cancer cases undergoing radical resection though it does not seem to benift cases receiving posterior pelvic exenteration.