全直肠系膜切除加盆腔自主神经保留术在男性直肠癌中的应用研究  

Application of total mesorectal excision with autonomic nerve preservation to males with rectal cancer

作　　者：秦长江[1] 任学群[1] 孙嵩洛[1] 傅侃达[1] 

机构地区：[1]河南大学淮河医院普外科,河南开封475000

出　　处：《中国现代医学杂志》2010年第23期3641-3643,3646,共4页China Journal of Modern Medicine

摘　　要：目的探讨保留盆腔自主神经(PANP)的全直肠系膜切除术(TME)对男性直肠癌患者术后排尿、性功能、复发和预后的影响。方法对2003年1月～2008年12月行PANP+TME的56例和同期行TME的55例男性直肠癌患者的术后排尿、性功能、复发和预后情况进行对比分析。结果 PANP+TME组和TME组患者术后勃起功能障碍的发生率分别为32.1%和65.5%,射精功能障碍发生率分别为39.3%和69.1%,两组比较差异有显著性(P<0.01)。排尿功能障碍发生率PANP+TME组为26.8%,TME组为60.0%,两组比较差异有显著性(P<0.01)。PANP+TME组和TME组两组患者局部复发率和5年生存率比较差异无显著性(P>0.05)。结论 PANP+TME不仅可明显改善患者的排尿功能和性功能,且能保证手术根治性,显著改善患者术后生活质量。【Objective】 To study the urinary functions,sexual functions,local recurrence and prognosis in male patients after total mesorectal excision（TME） with autonomic nerve preservation（PANP） for rectal cancer.【Methods】 Urinary functions,sexual functions,local recurrence and prognosis were prospectively analyzed in PANP＋TME group（56 cases） and TME（55 cases） group.【Results】 The erectile dysfunction rates were 32.1% and 65.5% in PANP＋TME group and TME group,and were found to be significantly different（P〈 0.01）.In the two groups,there were 39.3% and 69.1% of ejaculatory disorders with significant difference（P 〈0.01）.The urinary dysfunction rates were 26.8% and 60.0% in PANP＋TME and TME groups with significant difference（P〈 0.01）.There were no differences in local recurrent rate and the survival rate of 5 years between the TME and PANP ＋ TME groups（P 〉0.05）.【Conclusion】 PANP＋TME technique could enhance sexual and urination functions,at the same time ensure the radical cure of rectal cancer,and improve patients postoperative quality of life.

关 键 词：直肠肿瘤 盆腔自主神经丛 全直肠系膜切除术 

分 类 号：R735.37[医药卫生—肿瘤]