腹腔镜下低位直肠癌切除术中盆腔自主神经保留对患者复发及生存质量的影响

Influence of pelvic autonomic nerve preservation on life quality of patients with low rectal cancer after laparoscopic radical excision

目的:研究腹腔镜下低位直肠癌切除术并保留盆腔自主神经直肠癌根治术对患者术后排尿功能、性功能及术后复发率、生存率的影响。方法:选取我院手术治疗的64例男性直肠癌患者,随机分为腹腔镜加盆腔自主神经保留组(腹腔镜组)和开腹直肠癌根治术组(开腹组)各32例,比较两组患者临床疗效。结果:腹腔镜组患者术后排尿功能、勃起功能和射精功能等级优于开腹组(P<0.05)。腹腔镜组患者1、2年局部复发率及3年生存率分别为6.25%、12.50%、81.25%,与开腹组(3.13%、9.38%、84.38%)相比差异无统计学意义(P>0.05)。结论:男性直肠癌患者在腹腔镜下行低位直肠癌切除并保留盆腔自主神经的根治术,与非保留盆腔自主神经的开腹手术相比较,可以较好地保留排尿功能和男性性功能,且没有增加2年复发率和降低3年生存率。

Objective： To evaluate the influence of pelvic autonomic nerve preservation on sexual function and urination function in patients with low rectal cancer following laparoseopie operation. Methods： A total of 64 patients with low rectal cancer were divided into laparoscopic operation group and laparotomy group by half. Clinical effect was compared between two groups. Results： Erectile function, urination function, ejaculation function of Iaparoseopie operation group were better than laparotomy group（P〈0.05）. One year, two year reeurrenee rate and three year survival rate of laparoseopie operation group were 6.25%, 12. 50%,81. 25% showing no significant difference between two groups （3. 13%, 9.38%, 84.38%） （P〉0.05）. Conclusion： Laparoscopic operation plus pelvic autonomic nerve preservation has better effect on urination function and sexual function preservation without affecting two year recurrence rate and three year survival rate.