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目的探讨直肠全系膜切除术(TME)中保留盆腔自主神经(PANP)对术后男性患者性功能及排尿功能的影响。方法回顾性分析我院2008年1月至2010年10月期间行直肠癌根治术的84例患者临床资料,根据不同的手术方式分为PANP+TME组(n=41)和TME组(n=43),对2组患者术后排尿及性功能障碍发生率和局部复发率情况进行比较。结果 PANP+TME组与TME组患者术后勃起功能障碍发生率分别为29.3%(12/41)和76.7%(33/43),射精功能障碍发生率为26.8%(11/41)和79.1%(34/43),排尿障碍发生率分别为24.4%(10/41)和79.1%(34/43),2组间差异均有统计学意义(P<0.05)。PANP+TME组和TME组术后局部复发率分别为9.8%(4/41)和11.6%(5/43),2组比较差异无统计学意义(P>0.05)。结论直肠癌在TME基础上行PANP可以降低男性患者术后排尿和性功能障碍的发生率,且并不增加术后肿瘤局部复发率。
Objective To investigate the effect of preserving pelvic autonomic nerve (PANP) on the postoperative functional and urinary function in male patients undergoing total mesorectal excision (TME). Methods The clinical data of 84 patients undergoing radical resection of rectal cancer from January 2008 to October 2010 in our hospital were retrospectively analyzed. According to different surgical modalities, the patients were divided into three groups: PANP + TME group (n = 41) and TME group (n = 43) to compare the incidence of postoperative urination and sexual dysfunction and the local recurrence rate in two groups. Results The incidences of postoperative erectile dysfunction in PANP + TME group and TME group were 29.3% (12/41) and 76.7% (33/43), respectively. The incidence of ejaculation dysfunction was 26.8% (11/41) and 79.1% (34/43). The incidence of urinary disorders was 24.4% (10/41) and 79.1% (34/43), respectively. There was significant difference between the two groups (P <0.05). The local recurrence rates of PANP + TME group and TME group were 9.8% (4/41) and 11.6% (5/43) respectively, there was no significant difference between the two groups (P> 0.05). Conclusions PANP can reduce the incidence of postoperative urination and sexual dysfunction in patients with rectal cancer and does not increase the local recurrence rate after operation.