摘要
目的探讨保留盆腔自主神经(PANP)的全直肠系膜切除(TME)在男性直肠癌低位保肛术中的应用。方法回顾性分析传统手术、TME和PANP+TME在男性直肠癌保肛手术中的应用,对各组病人肿瘤下缘距肛门距离、3年存活率、局部复发率、排尿功能、性功能作一评价。结果TME组和PANP+TME组手术病人的肿瘤下缘距肛门距离较传统手术组明显缩短(P<0·05);3组的3年存活率分析差异无显著性(P>0·05);TME组和PANP+TME组的局部复发率较传统手术组明显降低(P<0·05);传统手术组、TME组、PANP+TME组的排尿障碍、勃起功能障碍和射精功能障碍的发生率逐渐降低,3组间两两比较差异均有显著性(P<0·05)。PANP手术分型与排尿障碍、勃起功能障碍和射精功能障碍分级呈正相关(P<0·05)。结论TME可以降低直肠癌的局部复发率,降低排尿障碍和性功能障碍的发生率;PANP和TME结合使排尿障碍和性功能障碍的发生率更加降低,PANP手术保留神经越彻底,手术后排尿障碍、性功能障碍的发生率越低。
Objective To study the effect of pelvic autonomic nerve preservation and total mesorectal excision in male rectal carcinoma patients for presersing anus. Methods The distance from tumor＇ s edge to anus,3 year＇ s survival rate, local recurence rate, urinary function and sexual function were propectively analysed in control groups, toltal mesorectal excision （TME） groups and pelvic autonomic nerve preservation （PANP） ＋ TME groups. Results The distance from tumor＇ s edge to anus in TME groups and PANP ＋ TME groups was shorter than one in control groups. The rate of urinary dysfunction and sexual dysfunction was gradualy reduced from control groups,TME groups to PANP ＋ TME groups. Those three groups had signifcant difference. Conclusion TME technique could signifcanfly reduce the local recurence rate,urinary dysfunction and sexual dysfunction. PANP combined with TME could reduce urinary dysfunction and sexual dysfunction much more.
出处
《中国实用外科杂志》
CSCD
北大核心
2006年第10期783-785,788,共4页
Chinese Journal of Practical Surgery
