腹腔镜直肠癌根治术保留盆腔植物神经效果分析

Effective analysis after laparoscopic radical resection of rectal cancer with pelvic autonomic nerve preservation

目的:探讨在腹腔镜直肠癌根治手术中保留盆腔植物神经(PANP)对男性局部复发率、生存率和术后生活质量的影响。方法:不同时期的2组腹腔镜直肠癌根治手术病人,其中非保留盆腔植物神经组34例,保留组88例,回顾性分析比较2组患者的局部复发率、5年存活率及术后排尿功能和性功能。结果:两组均顺利完成手术。其中保留植物神经组82例获得随访,未保留组28例获得随访。局部复发率保留植物神经组为7.3%(6/82),未保留组为7.1%(18/28);5年存活率保留植物神经组为84.2%(69/82),未保留组为82.1%(23/28),2组差异无统计学意义(P>0.05)。排尿功能障碍保留植物神经组为28.1%(23/82),未保留组为60.7%(17/28);勃起功能障碍保留植物神经组为24.4%(20/82),未保留组为67.9%(19/28);射精功能障碍保留植物神经组24.4%(20/82),未保留组71.4%,(20/28),两组比差异均有统计学意义(P<0.05)。结论:腹腔镜直肠癌根治术中保留植物神经功能,对局部复发率和5年存活率无明显影响,但可明显提高患者的生存质量。

Objective： To explore the relationship to rate of local recurrence, rate of survival and quality of life for colorectal cancer in laparoscopic radical surgew with pelvic autonomic nerve preservation（PANP）. Methods： Two groups of men were retrospectively analyzed in different peri- ods of laparoscopic surgew, including the pelvic autonomic nerve preservation group（study group） of 88 cases, and the non-preservation group （control group） of 34 cases on rate of local recurrence, a rate of 5-year survival and urinary function and sexual function. Results, All of the cases were completed successfully. The rate of local recurrence, the PANP group was 7.3% （6/82）and the control group was 7.1%（18/28）, （P〉0.05）. For the rate of 5-year survival, the PANP group was 84.2% （69/82）, and the control group was 82.1%（23/28）, （P〉0.05）. For the injured urinary function, the group of PANP was 28.1% （23/82）, and the control group was 60.7% （17/28）, （P〈0.05）. For the erectile dysfunction, the group of PANP was24.39% （20/82）, and the control group was 67.9% （19/28）, （P〈0.05）. For the ejaculatory disorder, the group of PANP was 24.4% （20/82）, and the control group was 71.4%, （20/28）, （P〈0.05）. Conclusion： The laparoscopic radical surgery with pelvic autonomic nerve preservation in rectal cancer would not increase the focal recurrence rate ,nor reduce the 5-year survival rate, but may evidently improve the life quality of man patients.