保留盆腔自主神经对男性直肠癌术后排尿功能的影响

Effects of pelvic autonomic nerve preservation on urinary function of male patients with rectal cancer

目的探讨直肠全系膜切除术(TME)和保留盆腔自主神经(PANP)两种术式对男性直肠癌患者术后排尿功能影响。方法收集滁州市第一人民医院南区胃肠外科2013年10月至2016年10月行直肠癌根治术的患者57例,31例为观察组行PANP+TME,同期26例为对照组行TME,通过测定膀胱残余尿量确定排尿功能分级,比较两组患者术后排尿功能变化情况。结果观察组和对照组在术后1周(Ⅰ级21例比8例,Ⅱ级8例比8例,Ⅲ级2例比7例,Ⅳ级0例比3例,Z=-3.212,P=0.001)、2周(Ⅰ级21例比10例,Ⅱ级9例比8例,Ⅲ级1例比6例,Ⅳ级0例比2例,Z=-2.686,P=0.007)排尿功能分级差异有统计学意义(P<0.05),两组术后6周排尿功能分级比较差异无统计学意义(Z=-1.747,P=0.081)。结论在TME的基础上行保留盆腔自主神经可显著的缩短男性直肠癌患者术后排尿功能障碍的恢复时间。

Objective To discuss the effects of two surgical methods of total mesorectal excision（TME） and pelvic autonomic nerve preservation（PANP） on urinary function of male patients with rectal cancer. Methods 57 patients with radical resection of rectal cancer in the first people＇s hospital of chuzhou from October 2013 to October 2016 were collected. 31 cases were treated with PANP ＋TME,at the same time,26 cases with TME. Urinary function classification were measured by residual urine volume. The changes of urinary function after operation in two groups were compared. Results The difference of urinary function of patients in the research group and control group at 1 weeks（Z =-3. 212,P = 0. 001） and 2 weeks（Z =-2. 686,P = 0. 007） after operation was statistically significant（P〈0. 05）. The difference of urinary function was not statistically significant in 6 weeks after operation（Z =-1. 747,P =0. 081）. Conclusion Pelvic autonomic nerve preservation on the basis of total mesorectal excision can significantly shorten the recovery time of voiding dysfunction in male patients with rectal cancer.