直肠癌Dixon手术中保留盆腔自主神经对男性性功能的保护作用

Effect of pelvic autonomic nerve preservation for sexual function after resection of rectal cancer in male patients by Dixion method

目的探索直肠癌经腹直肠前切除术(Dixon手术)术中保留盆腔自主神经对男性性功能的保护作用。方法按TME原则,对56例60岁以下的男性直肠癌患者施行了保留盆腔自主神经(PANP)的Dixon手术(治疗组),同期相同条件的病人,未行保留盆腔自主神经,作为对照组,观察2组术后勃起功能、射精功能和局部复发率。结果治疗组和对照组术后勃起功能障碍率分别为12.5%(7/56)和54.5%(36/66),射精功能障碍发生率分别为19.6%(11/56)和56.1%(37/66),治疗组明显低于对照组,治疗组和对照组局部复发率分别为8.3%(4/48)和8.8%(5/57),无明显差异。结论直肠癌Dixion手术术中保留盆腔自主神经对男性性功能有保护作用,并不增加局部复发率。

Objective To investigate the effect of pelvic autonomic nerve preservation（PANP） for sexual function after resection of rectal cancer in male patients by Dixion method. Methods According to total mesorectal excision （TME） method, a total of 56 patients hospitalized from October 2007 to October 2011 were enrolled into this study and received Dixion operation plus PANP combination treatment. Total 66 patients received Dixion operation without PANP in the same condition as control group. The clinical data of two group were analyzed retrospectively. Results Erectile dysfunction rate of patients in PANP group and control group was 12.5%（7/56） and 54.5%（36/66）, ejaculation disorder rate was 19.6%（11/56） and 56.1% （37/ 66）, respectively. The rate of sexual dysfunction of patients in PANP group was significantly lower than that in control group （P〈0.05）. Local recurrence rate of patients in PANP group（8.3%, 4/48） was similar to that in control group（8. 8%, 5/57）. Conclusion Dixion operation plus PANP combination treatment can improve the sexual function without increasing the postop- erative local recurrence rate.