[Urinary function after pelvic autonomic nerve preservation of laparoscopic radical resection for rectal cancer]

Zong-heng Zheng, Hong-bo Wei, Tu-feng Chen, Jiang-long Huang, Bo Wei, Bao-guang Hu, Feng Zheng, Wei-ping Guo, Yong Huang, Jie Situ
Zhonghua Yi Xue za Zhi [Chinese medical journal] 2009 November 17, 89 (42): 2976-9

OBJECTIVE: To evaluate the protection of urinary function after laparoscopic radical resection with pelvic autonomic nerve preservation (PANP) for rectal cancer.

METHODS: Prospectively 139 patients with middle or low rectal cancer receiving surgery during November 2005 to October 2007 were divided into two groups (L-PANP, n = 63; O-PANP, n = 76). The radicalism and safety of L-PANP surgery were analyzed and the effects upon urinary function between the two groups assessed by follow-ups and urodynamic study.

RESULTS: Patients receiving subtypes I and II of L-PANP surgery had less decrease in contraction of bladder than those receiving the same subtype of O-PANP surgery at 10 days post-operation (Z = -2.358, P = 0.018; Z = -2.268, P = 0.033). And no difference was observed in patients receiving subtype III PANP surgery (Z = -1.302, P = 0.237). However, no matter which subtype of PANP surgery, patients of L-PANP group had a better contraction of bladder than those of O-PANP group at 1 month post-operation (P < 0.05). The 1-year survival rate was 98.0% (50/51) in L-PANP group and 96.6% (57/59) in O-PANP group. And no statistical difference was found between them (P = 0.898). Meanwhile, the 1-year relapse rate of pelvic cavity was 3.9% (2/52) in L-PANP group and 5.1% (3/59) in O-PANP group. And no statistical difference was found between them (P = 0.867).

CONCLUSION: As compared with O-PANP surgery, L-PANP surgery shows a superiority in protection of urinary function.

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