腹腔镜直肠癌根治术保留Denonvilliers筋膜对男性患者术后排尿及性功能的影响分析  

Effect of preserving Denonvilliers' fascia in laparoscopic total mesorectum excision for rectal cancer on urinary and sexual function in male patients

作　　者：邓伟[1] 劳景茂[1] 韦小波[1] Deng Wei;Lao Jingmao;Wei Xiaobo(Department of Gastrointestinal Surgery,The First People’s Hospital of Qinzhou,Qinzhou 535000,Guangxi Zhuang Autonomous Region,China)

机构地区：[1]钦州市第一人民医院胃肠外科,广西钦州535000

出　　处：《结直肠肛门外科》2019年第2期156-159,共4页Journal of Colorectal & Anal Surgery

基　　金：广西壮族自治区卫计委自筹经费科研课题(Z20170971)

摘　　要：目的探讨腹腔镜直肠癌根治术中保留Denonvilliers筋膜对男性患者术后排尿功能及性功能的影响。方法回顾性分析2015年1月至2018年1月于本院接受腹腔镜下直肠癌全直肠系膜切除术的120例男性患者临床资料,按照术中处理的不同,分为观察组(保留Denonvilliers筋膜)与对照组(切除Denonvilliers筋膜),每组各60例。比较两组手术相关指标、术后排尿功能与性功能。结果观察组平均手术时间长于对照组,平均术中出血量少于对照组,术后首次肛门排气时间短于对照组,差异均有统计学意义(均P <0.05)。观察组排尿功能障碍严重程度轻于对照组,排尿障碍发生率低于对照组,差异均有统计学意义(均P <0.05)。观察组勃起功能障碍、射精功能障碍严重程度均轻于对照组,勃起功能障碍、射精功能障碍发生率均低于对照组,差异均有统计学意义(均P <0.05)。结论接受腹腔镜直肠癌全直肠系膜切除术保留Denonvilliers筋膜,有助于减少男性患者术后排尿功能障碍与性功能障碍的发生,提高患者生活质量。Objectives To investigate the effect of preserving Denonvilliers’fascia in laparoscopic total mesorectum excision for rectal cancer on urinary and sexual function in male patients.Methods This was a retrospective analysis of clinical data of 120 male patients who received laparoscopic total mesorectum excision in our hospital between January 2015 and January 2018.According to the surgical methods,patients were divided into treatment group,in which Denonvilliers’fascia was preserved,and control group,in which Denonwilliers’fascia was excised,with 60 patients in each group.Indices related to surgery,urinary and sexual function before and after surgery were compared between the two groups.Results Patients in the treatment group had significantly longer average duration of surgery,fewer intraoperative blood loss and shorter time to postoperative anal exhaust than those in the control group(P<0.05).Incidence and severity of voiding dysfunction were both significantly lower in the treatment group than in the control group(P<0.05).Incidence and severity of erectile and ejaculation dysfunction was significantly lower in the treatment group than in the control group(P<0.05).Conclusion Preserving Denonvilliers’fascia in laparoscopic total mesorectum excision could reduce the risk of postoperative voiding and sexual dysfunction and improve patients’quality of life in male patients.

关 键 词：直肠癌 全直肠系膜切除术 Denonvilliers筋膜 排尿功能 性功能 

分 类 号：R735.3[医药卫生—肿瘤]