保留盆腔自主神经在全直肠系膜切除术中的应用研究

The effects of pelvic autonomic nerve preservation in total mesorectal excision

目的研究保留盆腔自主神经在全直肠系膜切除术中的应用效果。方法入选96例直肠癌男性患者,按照随机数字方法分成两组,每组48例,其中对照组患者采取传统的直肠癌根治术,研究组则采取保留盆腔自主神经的全直肠系膜切除术,治疗后随访观察,比较分析两组患者的相关临床资料情况。结果研究组患者的排尿功能、勃起功能和射精功能均较对照组患者明显改善(P<0.05);两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论保留盆腔自主神经的全直肠系膜切除术不增加局部复发率、吻合口瘘发生率、切口感染发生率、骶前出血发生率的同时,还显著改善患者的泌尿和性功能,对直肠癌患者来说是一种较好的治疗选择。

Objective To investigate effects of the pelvic autonomic nerve preservation in total mesorectal excision. Methods 96 patients with rectal cancer were retrospectively reviewed and randomly divided into two groups, the pelvic autonomic nerve preser- vation（PANP）group（n：48 cases） and non-PANP group（n= 48 eases）,after operation, we compared the clinical data of the two groups. Results These were significant difference in urinary function, erectile function and ejaculatory function between the two groups （P〈0.05）. However, these was no significant difference in local recurrence rate, incidence of anastomotic leakage, wound infection rate,incidence of presacral bleeding between the two groups（P〉0.05）. Conclusion The pelvic autonomi, c nerve preservation not only not increase local recurrence rate,incidence of anastomotic leakage, wound infection rate,incidence of presacral bleeding,but also significantly improved the urinary and sexual function of patients with total mesorectal excision, it is a perfect option for the patients with cancer.