实时神经监测在腹腔镜直肠癌全直肠系膜切除术中盆腔自主神经丛保护的应用

Pelvic autonomic nerve preservation with real-time monitoring during laparoscopic total mesorectal excision for retal cancer

目的探讨实时神经监测在腹腔镜直肠癌全直肠系膜切除术中盆腔自主神经丛保护的应用。方法选取2017年1月至2020年12月非急诊收治的直肠癌患者,共11例。所有患者均进行腹腔镜直肠癌全直肠系膜切除术,术中使用实时神经监测进行盆腔自主神经丛保护,术后评估排尿、肛管直肠功能,并分析两者相关性。结果所有患者均成功进行术中实时神经监测,神经监测电生理结果均为阳性,术后第6月进行功能评估,均未发生排尿、肛管直肠功能不全,两者相关性良好(r=1.0)。结论实时神经监测在腹腔镜直肠癌全直肠系膜切除术中盆腔自主神经丛保护的应用安全、有效,结果阳性提示术后排尿、肛管直肠功能完好。

Objective To study pelvic autonomic nerve preservation using real-time minitoring during laparoscopic total mesorectal excison for rectal cancer.Methods We prospectively investegated 11 cases of rectal cancer patients undergoing laparoscopic TME during January 2018 and December 2020.PANP procedure was done using real-time monitoring.The urinary and anorectal function and the correlation between the electromyography and postoperative function were analysed.Results All patients were succsessfully perfomed PANP with real-time monitoring,and all get positive results.The postoperative urinary and anorectal functions of all patients were complete.The correlation between the electromyography and postoperative function was very good(r=1.0).Conclusion Pelvic autonomic nerve preservation using real-time minitoring during laparoscopic total mesorectal excison for rectal cancer is safe and effective and the positive electromyography indicates a complete urinary and anoretal function.