保留盆腔自主神经的全直肠系膜切除术对中、低位直肠癌患者术后排尿和性功能影响的临床研究

Effect of pelvic autonomic nerve preservation with total mesorectal excision on urinary and sexual function in male mid-low rectal carcinoma patients for preserving anus

目的探讨保留盆腔自主神经(PANP)的全直肠膜切除(TME)在男性中、低位直肠癌低位保肛术中的应用。方法回顾性分析TME和PANP+TME在男性中、低位直肠癌保肛手术中的应用,对各组病人肿瘤下缘距肛门距离、3年存活率、局部复发率、排尿功能及性功能作一评价。结果TME组和PANP+TME组两组病人3年存活率比较差异无显著性(P>0.05);TME组和PANP+TME组的局部复发率差异无显著性(P>0.05);TME组、PANP+TME组的排尿障碍、勃起功能和射精功能障碍的发生率逐渐降低,两组间比较差异均有显著性(P<0.05)。结论保留盆腔自主神经(PANP)的全直肠膜切除(TME)可以降低排尿障碍、性功能障碍和射精功能障碍的发生率,值得临床推广应用。

[Objective] To study the effect of pelvic autonomic nerve preservation with total mesorectal excision on urinary and sexual function in male mid-low rectal carcinoma patients for preserving anus. [Methods] The survival rate of 3 years, local recurence rate, urinary function and sexual function were retropectively analysed in total mesorectal excision （TME） groups and pelvic autonomic nerve preservation （PANP） ＋ TME group. [Results] There is no difference of the survival rate of 3 years, local recurence rate between the TME and PANP ＋ TME group. But the rate of urinary dysfunction and sexual dysfunction were significantly reduced in TME group compared with PANP ＋ TIME group. [Conclusion] PANP ＋ TME technique could signifcanfly reduce the urinary dysfunction and sexual dysfunction.