直肠癌TME中保留盆腔自主神经对男性排尿及性功能影响的初步研究

Assessment of urinary and sexual function after total mesorectal excision with pelvic autonomic nerve preservation in males with rectal cancer

目的:探讨保留盆腔自主神经(pelvic autonomic nerve preservation,PANP)的直肠全系膜切除术(totalmesorectalexcision,TME)对男性排尿及性功能的影响。方法:对2005～2006年48例进行TME(对照组)和2007～2008年进行PANP+TME的53例(治疗组)男性直肠癌患者的排尿及性功能情况进行回顾性分析。结果:术后勃起功能障碍的发生率为治疗组28.30%(15/53),对照组72.92%(35/48),2组差异有统计学意义(P<0.001);射精功能障碍的发生率为治疗组24.53%(13/53),对照组62.50%(30/48),2组差异有统计学意义(P=0.001);排尿障碍的发生率为治疗组18.87%(10/53),对照组47.92%(23/48),2组差异有统计学意义(P<0.001)。结论:PANP和TME结合可以明显改善患者的排尿功能和性功能,从而提高患者术后生活质量。

Objective：To study the sexual and urinary functions in male patients after radical resection with pelvic autonomic nerve preservation for rectal cancer. Methodst We performed a standard questionnaire using the International Index of Erectile Function before and after pelvic autonomic nerve preservation surgery in 53 males with rectal cancer compared with traditional surgery in 48 males, Results： In TME ＋PANP and TME groups,the incidence Of erectile dysfunction was 28.30% and 72.92%; the incidence of ejaculation disorder was 24.53 %and 61.67%; the incidence of urination dysfunction was 18.87% and 48.33% .The significant differences ,were doserved between the two groups （P〈0.01）. Conclusion：The radical operation with PANP for rectal cancer can enhance sexual and urination functions and improve patients post-operation quality of life.