腹腔镜直肠癌根治术中保护盆腔植物神经的体会

Protection of pelvic autonomic nerve in the laparoscopic radical resection of rectal neoplasms

目的:探讨腹腔镜直肠癌根治术中显露及保护盆腔植物神经对患者术后性功能和排尿功能的影响。方法:回顾分析2005年5月至2008年3月我院为11例男性直肠癌患者施行腹腔镜全直肠系膜切除术(total mesorectal excision,TME)的基础上保留盆腔植物神经(pelvic autonomic nervepreservation,PANP),降低术后排尿及性功能障碍发生率的临床资料。结果:患者术后勃起功能障碍发生率9.09%,射精功能障碍发生率18.18%,近期排尿障碍发生率9.09%。结论:腹腔镜TME基础上行PANP与传统开腹TME基础上行PANP相比,术中能更清晰地显露盆腔植物神经并予以保护,减少了术后排尿和性功能障碍的发生。

Objective：To discuss the effects of exposure and protection pelvic autonomic nerve for post-operative of urination and sex function. Methods： Eleven male patients with rectal carcinoma underwent laparoscopic total mesorectal excision （TME） and pelvic autonomic nerve preservation（PANP） from May 2005 to March 2008. The clinical data of decrease in post-operative urination disorders and sex disorders rate were analyzed retrospectively. Results：The rate of post-operative erectile dysfunction was 9.09%, ejaculatory dysfunction rate was 18.18%, recent urination disorders rate was 9.09%. Conclusions： Compared with laparotomy TME ＋ PANP,it is easier for exposure and protection pelvic autonomic nerve in laparoscopie TME ＋ PANP, and the latter decrease the rate of post-operative rate of urination disorders and sex disorders.