直肠癌根治术中保留盆腔植物神经对男性性功能和排尿的影响

Effects of Radical Resection of Rectal Cancer with Pelvic Autonomic Never Preserving and the Postoperation on Sexual and Urinary Functions

目的探讨直肠癌根治术中保留盆腔植物神经对男性直肠癌患者术后性功能和排尿功能的影响。方法151例直肠癌患者随机分为两组:治疗组79例和对照组72例。治疗组行Miles术,术中保留盆腔植物神经;对照组采用常规直肠癌根治手术,术中不保留盆腔植物神经。结果术后勃起功能障碍的发生率:治疗组为27.85%(22/79),对照组为73.61%(53/72),两组比较,有极显著性差异(P<0.001);射精功能障碍的发生率:治疗组为32.91%(26/79),对照组为79.17%(57/72),两组比较,有极显著性差异(P<0.001);近期排尿障碍的发生率:治疗组为18.99%(15/79),对照组为48.61%(35/72),两组比较,有极显著性差异(P<0.001)。远期排尿障碍的发生率:治疗组为0.00%(0/79);对照组5.56%(4/72),两组比较,有极显著性差异(P<0.001)。结论直肠癌根治术中实施保留盆腔植物神经,可以改善患者的性功能和排尿功能,提高患者术后生活质量。

Objective To evaluate the sexual and urinary functions after pelvic autonomic never preserving in radical resection for rectal cancer in male patients. Methods Retrospectively, the sexual and urinary functions of 66 patients in PANP group and 66 patients in control group were analysed. Results In PANP and non-PANP groups, the incidence of erectile dysfunction was 27.85% and 73.61%,for the incidence of ejaculation disorder,32.91%and 79.17% ,18.99% and 48.61% for the incidence of temporary urination dysfunction,and 0 and 5.56 % for the incidence of long-term urination dysfunction, with significant difference in all the above incidence between the two groups （P〈0.001）. Conclusion The radical operation with PANP for rectal cancer can enhance sexual and urination functions, and improve patients post-operation quality of life.