保留腹腔植物神经丛的直肠癌扩大根治术  

Autonomic-nerve-preserving extended radical operation for rectal cancer

作　　者：刘忠臣[1] 董新舒[2] 刘平果[1] 

机构地区：[1]厦门市中山医院普外科,361004 [2]哈尔滨医科大学附属三院腹外科

出　　处：《中华普通外科杂志》2000年第11期665-666,共2页Chinese Journal of General Surgery

摘　　要：目的　评价男性保留植物神经的直肠癌扩大根治术 ,对减少患者术后泌尿和性功能障碍的作用。方法　对 80例DukesB、C期直肠癌患者行保留植物神经的直肠癌扩大根治术 (其中 10例为保留单侧植物神经 ) ,另外 2 5例 (DukesB、C期 )行单纯直肠癌扩大根治术。结果　保留双侧植物神经的 70例术后勃起、射精、完成性交及出现性高潮者分别为 97 1%、92 9%、91 4%和 88 5 % ;10例保留单侧植物神经者 ,分别为 :7/ 10、5 / 10、4/ 10、4/ 10 ;2 5例未保留植物神经者全部丧失性功能。植物神经保留组 3例出现近期尿潴留 ,未保留组 2 3例 (92 % )有近期尿潴留 ,7例 (2 8% )有远期尿潴留。结论　保留植物神经的直肠癌扩大根治术能够有效地减少患者术后性功能和泌尿功能障碍。Objective To evaluate autonomic nerve preserving extended operation (ANPEO) for rectal cancer in the protection of postoperative urinary and male sexual functions.[WT5”HZ]Methods [WT5”BZ] 80 Dukes B and C cases underwent ANPEO for rectal cancer, including 10 cases with unilateral ANPEO. Result was compared with that of 25 cases undergoing traditional extended radical operation. [WT5”HZ] Result [WT5”BZ] Among 70 cases with bilateral ANPEO and 10 cases with unilateral ANPEO normal postoperative erectile was maintained in 97 1% vs 70%, ejaculatory functions in 92 9% vs 50%, ability of sexual intercourse in 91% vs 40%, and orgasm in 88 5% vs 40% respectively. In 25 cases without ANPEO extended operation sexual functions were all lost. 3/80 cases with ANPEO suffered temporary urinary dysfunction, 23/25 cases without ANPEO suffered temporary urinary dysfunction and 7 with long term dysfunction [WT5”HZ]Conclusions [WT5”BZ] ANPEO is effective to reduce the postoperative urinary and sexual dysfunction while maintaining the radical cure for the cancer.

关 键 词：直肠肿瘤 自主神经系统 性功能障碍 泌尿功能障碍 

分 类 号：R735.370.5[医药卫生—肿瘤]