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作 者:鲍乐锋[1] 金正贤[1] 马伟达[1] 徐晓忠[1]
机构地区:[1]南京中医药大学附属张家港市中医医院普外科,江苏张家港215600
出 处:《临床医学工程》2012年第9期1489-1491,共3页Clinical Medicine & Engineering
摘 要:目的探讨直肠全系膜切除术(TME)保留盆腔自主神经(PANP)对男性直肠癌患者性功能、泌尿功能及远期生存率的影响。方法选择2005年至2007年我院收治的直肠癌患者132例,随机分为观察组66例,行TME+PANP治疗;对照组66例,行常规TME治疗。术后半年随访评价患者的性功能及泌尿功能,随访5年观察患者局部复发情况及生存率。结果观察组泌尿功能及性功能障碍发生率较对照组低(P<0.05),术后3年两组的局部复发率为7.6%、10.6%,生存率为76.3%、73.2%;术后5年两组的局部复发率分别为57.6%、60.6%,生存率为55.2%、50.4%。两组间的差异无统计学意义(P>0.05)。结论直肠癌全系膜切除术中保留盆腔自主神经可以较好地保护老年男性患者的性功能及泌尿功能,且不影响患者的远期生存情况。Objective To investigate the effect of total mesorectal excision (TME) with pelvic autonomic nerve preservation (PANP) for rectal cancer on urinary and sexual function, survival situation. Methods 132 patients with rectal cancer in our hospital from 2005 to 2007 were randomly divided into two groups. 66 patients of the observation group received the treatment ofTME + PANP, while 66 cases of the control group received the conventional TME treatment. The urinary and sexual fi.mctions were evaluated 6 months after operation; the local recurrence rates and survival rate were observed with follow-up for 5 years. Results The incidences of urinary dysfunction and sexual dysfunction of observation group were lower than those of control group (P 〈0.05). The postoperative follow-up of 3 years showed that local recurrence rate of the observation group and control group was 7.6% and 10.6% respectively, and the 3-year-survival rate of the two grous was 76.3% and 73.2% respectively. The local recurrence rate 5 years after the operation and 5-year-survival rate of the observationgroup and control group was 57.6%, 60.6% and 55.2%, 50.4% respectively. All of these index were found no significant difference (P 〉0.05). Conclu- sions The PANP technique in TME can improve the urinary and sexual function of old male patients without affecting the prognosis.
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