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目的探讨男性直肠癌患者行全直肠系膜切除(TME)并保留盆腔自主神经(PANP)根治性切除术的临床意义。方法对30例男性直肠癌患者行TME+PANP手术,对27例男性直肠癌患者仅行TME非保留盆腔自主神经根治术,术后1年调查患者的病死率、复发率,并评价患者的排尿功能及性功能(包括勃起功能和射精功能)。结果两组术后1年均无死亡病例,TME+PANP组术后1年复发3例,TME组复发1例,两组复发率比较差异无统计学意义(P>0.05)。患者术后排尿功能TME+PANP组与TME组比较差异无统计学意义(P>0.05);术后勃起功能:TME+PANP组得分高于TME组(P<0.05),射精功能优于TME组(P<0.05)。结论进展期直肠癌患者实施保留盆腔自主神经的根治术,可以较好地保留患者的性功能。
Objective To investigate the clinical significance of total mesorectal excision (TME) and radical excision of pelvic autonomic nerve (PANP) in male patients with rectal cancer. Methods TME+PANP was performed in 30 men with rectal cancer. TME non-retained pelvic autonomic nerve was performed in 27 men with rectal cancer. The mortality and recurrence rate of the patients were investigated 1 year after surgery. The patient’s urination was evaluated. Functional and sexual functions (including erectile function and ejaculation function). Results There were no deaths in both groups at 1 year after surgery. TME+PANP group had recurrence in 3 cases at 1 year and relapse in 1 case in TME group. There was no significant difference in recurrence rate between the two groups (P>0.05). There was no significant difference in postoperative micturition function between TME+PANP group and TME group (P>0.05). Postoperative erectile function was higher in TME+PANP group than in TME group (P<0.05). Ejaculatory function was better than TME group. (P<0.05). Conclusions Patients with advanced rectal cancer undergoing radical pelvic autonomic nerve resection can retain their sexual function better.