Objective:To investigate and analyze the effect of laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer on urinary and sexual function.Methods:Cases of laparoscopic radical resection of re...Objective:To investigate and analyze the effect of laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer on urinary and sexual function.Methods:Cases of laparoscopic radical resection of rectal cancer in our hospital from April 2018 to April 2023 were selected,and 60 patients who met the requirements were included as research subjects.The patients were divided into an experimental group and a reference group by a double-blind mechanism,with 30 cases in each group.The experimental group underwent laparoscopic pelvic autonomic radical resection,while the reference group underwent ordinary radical resection.The voiding function,urodynamics,sexual function,and blood indexes of the patients of both groups were compared.Results:The total incidence of voiding dysfunction in the experimental group was significantly lower than in the reference group(P<0.05).Urodynamics such as abdominal leak point pressure(ALPP),maximum urethral pressure(MUP),maximum urethral closure pressure(MUCP),and functional urethral length(FUL)in the experimental group were significantly better than those in the reference group(P<0.05).The incidences of erectile dysfunction and ejaculatory dysfunction in the experimental group were significantly lower than those in the reference group(P<0.05).Before the surgery,there were no significant differences in the blood indexes such as C-reactive protein(CRP),cortisol(Cor),and pre-albumin(PA)between the two groups(P>0.05);after the operation,the blood indexes of the patients in the experimental group were significantly better than those in the reference group(P<0.05).Conclusion:Laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer has lesser effects on urinary and sexual functions.展开更多
The clinical effect of laparoscopic rectal cancer curative excision with pelvic autonomic nerve preservation（PANP） was investigated. This study evaluated the frequency of urinary and sexual dysfunction of 149 male p...The clinical effect of laparoscopic rectal cancer curative excision with pelvic autonomic nerve preservation（PANP） was investigated. This study evaluated the frequency of urinary and sexual dysfunction of 149 male patients with middle and low rectal cancer who underwent laparoscopic or open total mesorectal excision with pelvic autonomic nerve preservation（PANP） from March 2011 to March 2013. Eighty-four patients were subjected to laparoscopic surgery, and 65 to open surgery respectively. The patients were followed up for 12 months, interviewed, and administered a standardized questionnaire about postoperative functional outcomes and quality of life. In the laparoscopic group, 13 patients（18.37%） presented transitory postoperative urinary dysfunction, and were medically treated. So did 12 patients（21.82%） in open group. Sexual desire was maintained by 52.86%, un-ability to engage in intercourse by 47.15%, and un-ability to achieve orgasm and ejaculation by 34.29% of the patients in the laparoscopic group. Sexual desire was maintained by 56.36%, un-ability to engage in intercourse by 43.63%, and un-ability to achieve orgasm and ejaculation by 33.73% of the patients in the open group. No significant differences in urinary and sexual dysfunction between the laparoscopic and open rectal resection groups were observed（P〉0.05）. It was concluded that laparoscopic rectal cancer radical excision with PANP did not aggravate or improve sexual and urinary dysfunction.展开更多
Objective： To evaluate the influence of complete and incomplete pelvic autonomic nerve preservation （PANP） on urination function in patients with resection of rectal carcinoma. Methods： The changes of pre-and post...Objective： To evaluate the influence of complete and incomplete pelvic autonomic nerve preservation （PANP） on urination function in patients with resection of rectal carcinoma. Methods： The changes of pre-and post-operative residual urine volume （RUV） in patient undergoing complete PANP （n = 15） and incomplete PANP （n = 17） were observed. Results： In fifteen cases with complete PANP, preoperative RUV was 4.09 ml, 14 days and 3 months after operation RUV were 8.00 ml and 7.02 ml （P 〉 0.05）. In seventeen cases with incomplete PANP, preoperative RUV was 3.90 ml, 14 days and 3 months after operation RUV were 36.55 ml and 22.64 ml （P 〈 0.001 ）. Conclusion： Complete and incomplete pelvic autonomic preservation may affect urination function in patients with resection of rectal carcinoma and RUV is an effective indicator if the pelvic autonomic nerves are preserved completely.展开更多
The advent of total mesorectal excision(TME)together with minimally invasive techniques such as laparoscopic colorectal surgery and robotic surgery has improved surgical results.However,the incidence of bladder and se...The advent of total mesorectal excision(TME)together with minimally invasive techniques such as laparoscopic colorectal surgery and robotic surgery has improved surgical results.However,the incidence of bladder and sexual dysfunction remains high.This may be particularly distressing for the patient and troublesome to manage for the surgeon when it does occur.The increased use of neoadjuvant and adjuvant radiotherapy is also associated with poorer functional outcomes.In this review,we evaluate current understanding of the anatomy of pelvic nerves which are divided into the areas of the inferior mesenteric artery pedicle,the lateral pelvic wall and dissection around the urogenital organs.Surgical techniques in these areas are discussed.We also discuss the results in functional outcomes of the various techniques including open,laparoscopic and robotic over the last 30 years.展开更多
目的系统评价中低位直肠癌全直肠系膜切除手术中保留盆腔自主神经治疗的临床价值。方法使用Rev Man 5.4软件,检索中国知网、维普网、万方数据知识服务平台、中国生物医学文献服务系统、Cochrane Library、Pub Med、EMbase数据库和Web of...目的系统评价中低位直肠癌全直肠系膜切除手术中保留盆腔自主神经治疗的临床价值。方法使用Rev Man 5.4软件,检索中国知网、维普网、万方数据知识服务平台、中国生物医学文献服务系统、Cochrane Library、Pub Med、EMbase数据库和Web of Science数据库,筛选出全直肠系膜切除手术中保留盆腔自主神经治疗的中低位直肠癌的随机对照试验(RCT),检索期限为建库至2023年4月,采用Rev Man 5.4软件进行meta分析。结果最终纳入10篇RCTs,包括899例患者。结果显示:观察组术后勃起功能障碍发生率低于对照组[RR=0.46,95%CI(0.38~0.58),P<0.00001];观察组术后射精功能障碍发生率低于对照组[RR=0.54,95%CI(0.46~0.65),P<0.00001];观察组术后排尿功能影响低于对照组[RR=0.38,95%CI(0.29~0.51),P<0.00001];两组肿瘤复发率比较,差异无统计学意义[RR=0.82,95%CI(0.45~1.52),P=0.53]。结论在中低位直肠癌的手术治疗中,相较于传统直肠癌根治术,全直肠系膜切除术中保留盆腔自主神经虽未明显改善复发率,但可保护术后性功能和排尿功能,提高生活质量,具有临床价值。展开更多
文摘Objective:To investigate and analyze the effect of laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer on urinary and sexual function.Methods:Cases of laparoscopic radical resection of rectal cancer in our hospital from April 2018 to April 2023 were selected,and 60 patients who met the requirements were included as research subjects.The patients were divided into an experimental group and a reference group by a double-blind mechanism,with 30 cases in each group.The experimental group underwent laparoscopic pelvic autonomic radical resection,while the reference group underwent ordinary radical resection.The voiding function,urodynamics,sexual function,and blood indexes of the patients of both groups were compared.Results:The total incidence of voiding dysfunction in the experimental group was significantly lower than in the reference group(P<0.05).Urodynamics such as abdominal leak point pressure(ALPP),maximum urethral pressure(MUP),maximum urethral closure pressure(MUCP),and functional urethral length(FUL)in the experimental group were significantly better than those in the reference group(P<0.05).The incidences of erectile dysfunction and ejaculatory dysfunction in the experimental group were significantly lower than those in the reference group(P<0.05).Before the surgery,there were no significant differences in the blood indexes such as C-reactive protein(CRP),cortisol(Cor),and pre-albumin(PA)between the two groups(P>0.05);after the operation,the blood indexes of the patients in the experimental group were significantly better than those in the reference group(P<0.05).Conclusion:Laparoscopic pelvic autonomic nerve-preserving radical resection of rectal cancer has lesser effects on urinary and sexual functions.
文摘The clinical effect of laparoscopic rectal cancer curative excision with pelvic autonomic nerve preservation（PANP） was investigated. This study evaluated the frequency of urinary and sexual dysfunction of 149 male patients with middle and low rectal cancer who underwent laparoscopic or open total mesorectal excision with pelvic autonomic nerve preservation（PANP） from March 2011 to March 2013. Eighty-four patients were subjected to laparoscopic surgery, and 65 to open surgery respectively. The patients were followed up for 12 months, interviewed, and administered a standardized questionnaire about postoperative functional outcomes and quality of life. In the laparoscopic group, 13 patients（18.37%） presented transitory postoperative urinary dysfunction, and were medically treated. So did 12 patients（21.82%） in open group. Sexual desire was maintained by 52.86%, un-ability to engage in intercourse by 47.15%, and un-ability to achieve orgasm and ejaculation by 34.29% of the patients in the laparoscopic group. Sexual desire was maintained by 56.36%, un-ability to engage in intercourse by 43.63%, and un-ability to achieve orgasm and ejaculation by 33.73% of the patients in the open group. No significant differences in urinary and sexual dysfunction between the laparoscopic and open rectal resection groups were observed（P〉0.05）. It was concluded that laparoscopic rectal cancer radical excision with PANP did not aggravate or improve sexual and urinary dysfunction.
文摘Objective： To evaluate the influence of complete and incomplete pelvic autonomic nerve preservation （PANP） on urination function in patients with resection of rectal carcinoma. Methods： The changes of pre-and post-operative residual urine volume （RUV） in patient undergoing complete PANP （n = 15） and incomplete PANP （n = 17） were observed. Results： In fifteen cases with complete PANP, preoperative RUV was 4.09 ml, 14 days and 3 months after operation RUV were 8.00 ml and 7.02 ml （P 〉 0.05）. In seventeen cases with incomplete PANP, preoperative RUV was 3.90 ml, 14 days and 3 months after operation RUV were 36.55 ml and 22.64 ml （P 〈 0.001 ）. Conclusion： Complete and incomplete pelvic autonomic preservation may affect urination function in patients with resection of rectal carcinoma and RUV is an effective indicator if the pelvic autonomic nerves are preserved completely.
文摘The advent of total mesorectal excision(TME)together with minimally invasive techniques such as laparoscopic colorectal surgery and robotic surgery has improved surgical results.However,the incidence of bladder and sexual dysfunction remains high.This may be particularly distressing for the patient and troublesome to manage for the surgeon when it does occur.The increased use of neoadjuvant and adjuvant radiotherapy is also associated with poorer functional outcomes.In this review,we evaluate current understanding of the anatomy of pelvic nerves which are divided into the areas of the inferior mesenteric artery pedicle,the lateral pelvic wall and dissection around the urogenital organs.Surgical techniques in these areas are discussed.We also discuss the results in functional outcomes of the various techniques including open,laparoscopic and robotic over the last 30 years.
文摘目的系统评价中低位直肠癌全直肠系膜切除手术中保留盆腔自主神经治疗的临床价值。方法使用Rev Man 5.4软件,检索中国知网、维普网、万方数据知识服务平台、中国生物医学文献服务系统、Cochrane Library、Pub Med、EMbase数据库和Web of Science数据库,筛选出全直肠系膜切除手术中保留盆腔自主神经治疗的中低位直肠癌的随机对照试验(RCT),检索期限为建库至2023年4月,采用Rev Man 5.4软件进行meta分析。结果最终纳入10篇RCTs,包括899例患者。结果显示:观察组术后勃起功能障碍发生率低于对照组[RR=0.46,95%CI(0.38~0.58),P<0.00001];观察组术后射精功能障碍发生率低于对照组[RR=0.54,95%CI(0.46~0.65),P<0.00001];观察组术后排尿功能影响低于对照组[RR=0.38,95%CI(0.29~0.51),P<0.00001];两组肿瘤复发率比较,差异无统计学意义[RR=0.82,95%CI(0.45~1.52),P=0.53]。结论在中低位直肠癌的手术治疗中,相较于传统直肠癌根治术,全直肠系膜切除术中保留盆腔自主神经虽未明显改善复发率,但可保护术后性功能和排尿功能,提高生活质量,具有临床价值。
