腹腔镜直肠癌根治术中盆腔自主神经的保护

The Protection of Pelvic Autonomic Nerve in Laparoscopic Radical Resection of Rectal Carcinoma

目的探讨开腹保留盆腔自主神经的直肠癌根治术与腹腔镜经肛拖出直肠癌根治术中保留盆腔自主神经对男性性功能以及排尿情况的影响。方法选取我院2013年10月到2016年10月收治的男性中低位直肠癌患者98例作为研究对象,根据治疗方式分为开腹组50例和微创组48例,开腹组给予开腹保留盆腔自主神经的直肠癌根治术治疗,微创组给予腹腔镜经肛拖出直肠癌根治术治疗,观察比较两组患者治疗后的排尿功能、勃起功能、射精功能。结果微创组的排尿功能障碍率、勃起功能障碍率以及射精功能障碍率分别为6.25%、6.25%、4.17%,均显著低于开腹组的20.00%、24.00%、20.00%(P<0.05)。结论腹腔镜经肛拖出直肠癌根治术可更好地保护患者的盆腔自主神经,帮助患者保留排尿和性功能,具有一定的可行性和安全性。

Objective To investigate the influences of open radical resection of rectal carcinoma with pelvic autonomic nerve preservation and laparoscopic radical resection of rectal carcinoma with colon pulled through anus on the male sex function and urination condition. Methods 98 cases of male patients with mid-low rectal carcinoma admitted to our hospital from October 2013 to October 2016 were selected. According to the treatment methods, all cases were divided into the open surgical group （n = 50, open radical resection of rectal carcinoma with pelvic autonomic nerve preservation） and the minimally invasive group （n = 48, laparoscopic radical resection of rectal carcinoma with colon pulled through anus）. The micturition function, erectile function and ejaculation function after treatment were observed and compared between two groups. Results The rate of micturition dysfunction, rate of erectile dysfunction and rate of ejaculation dysfunction of minimally invasive group were 6.25%, 6.25% and 4.17% respectively, significantly lower than 20.00%, 24.00% and 20.00% of open surgical group （all P 〈0.05）. Conclusions Laparoscopic radical resection of rectal carcinoma with colon pulled through anus is feasible and safe, which can better protect the pelvic autonomic nerve, and retain the urinary and sexual functions of patients.