腹腔镜保留盆腔自主神经直肠癌根治术对患者排尿及男性性功能影响的Meta分析  

Influence of laparoscopic radical resection for rectal carcinoma with pelvic autonomic nerve preservation on urinary function and male sexual function of patients:a meta-analysis

作　　者：凌云志[1] 张宏[1] 丛进春[1] 崔明明[1] 冯勇[1] 陈春生[1] 

机构地区：[1]中国医科大学附属盛京医院结肠直肠肿瘤外科,辽宁沈阳110004

出　　处：《中国医刊》2015年第2期39-44,共6页Chinese Journal of Medicine

基　　金：辽宁省自然科学基金资助项目(2013021098)

摘　　要：目的比较腹腔镜与开腹保留盆腔自主神经(pelvic autonomic nerve preservation,PANP)的直肠癌根治术对患者术后排尿功能及男性性功能的保护效果。方法计算机检索Pubmed、Springer、OVID、Cochrane library、中国知网、维普数据库和万方数据库,检索时间均为1991年1月至2014年3月;应用Cochrane协作网提供的RevMan5.2软件进行Meta分析。结果最终纳入研究12篇,总样本量994例,其中腹腔镜组(L-PANP)464例,传统开腹组(O-PANP)530例。术后短期(<2周)和长期(>1个月)排尿功能障碍发生率比较,O-PANP组均高于L-PANP组,差异有显著性(P<0.01,P=0.03);术后6个月性功能障碍发生率比较,O-PANP组高于L-PANP组,差异有显著性(P<0.01);术后3个月和12个月性功能障碍发生率差异无显著性(P=0.37,P=0.1)。结论直肠癌患者实施腹腔镜PANP手术能减少术后排尿功能障碍和短期男性性功能障碍,有利于提高患者术后生活质量。Objective To evaluate the protection of urinary function and male sexual function after laparoscopic radical resection with pelvic autonomic nerve preservation （PANA）for rectal cancer patients. Method The published studies of comparing urinary function and sexual function between L-PANP and O-PANP from January 1991 to March 2014 were searched from Pubmed,Springer, OVID, Cochrane library, CNKI, Vip data and Wanfang data. The RevMan 5.2 software was used for data analyses. Result 12 studies including 994 cases were analyzed. A total of 464 patients received L-PANP surgery, there were 530 cases undergoing O-PANP surgery. Short-term（ 〈2 weeks） and long-term （〉 1 month） urinary dysfunction after operation were significantly higher in O-PANP group than L-PANP group, the difference was statistically significant （P〈0. 01 ,P = 0.03 ）. Sexual dysfunction on 6 months after operation was higher in O-PANP group than L-PANP group,the difference was statistically significant（ P〈0.01 ）. But there was not statistically difference of sexual dysfunction on 3 months and 12 months after operation between O-PANP group and L-PANP group（P = 0. 37,P= 0.1 ）. Conclusion Laparoscopic radical resection for rectal carci- noma with pelvic autonomic nerve preservation can reduce the incidence of postoperative urinary dysfunction and short-term male sexual dysfunction. L-PANP surgery can help improve the quality of life of patients after surgery.

关 键 词：腹腔镜 直肠癌 盆腔自主神经 排尿功能 性功能 

分 类 号：R697[医药卫生—泌尿科学]