腹腔镜下保留盆腔自主神经的全直肠系膜切除术在中低位男性直肠癌中的临床效果

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Abstract Objective To explore the clinical safety and efficacy of total mesorectal excision (TME) with pelvic autonomic nerve preservation (PANP) by laparoscopy in male patients with middle and low rectal cancer. Methods From October 2014 to October 2016, a total of 112 patients diagnosed with middle and low rectal cancer (AJCC clinical stages Ⅰ～Ⅲ) in No.169 Hospital of PLA were selected as the research subjects. All the patients reserved TME+PANP. They were divided into the control group and the observation group by random number table, with 56 cases in each group. The control group received open surgery and the observation group adopted laparoscopy. The mean operation time, blood loss, drainage volume, indwelling time, gastrointestinal function recovery time and activity time on ground, successful rate of operation and incidence of perioperative complications were compared between the two groups. The scores visual analogue scale (VAS) after operation of 1, 3 d and 7 d were compared between the two groups. The rates of erectile dysfunction, ejaculatory dysfunction, voiding dysfunction and local recurrence were compared between the two groups after at least one year follow-up. Results There was no statistically significant difference in the mean operation time between the two groups (P ＞ 0.05). The blood loss, drainage volume, indwelling time, gastrointestinal function recovery time and activity time in observation group were all significantly lower than those of control group, with statistically significant differences (P ＜ 0.05). There were both 100% successful rate of operation in the two groups, but the incidence of complications in the observation group was lower than that of control group, after operation of 1, 3 d and 7 d, VAS scores in observation group were all lower than those of control group, with statistically significant differences (P ＜ 0.05). The rates of erectile dysfunction, ejaculatory dysfunction and voiding dysfunction in the observation group were all lower than those of control group, with statistically significant differences (P ＜ 0.05). There was no statistically significant difference in the local recurrence rate between the two groups (P ＞ 0.05). Conclusion There is better clinical safety and efficacy of TME+PANP with laparoscopy in male patients of middle and low rectal cancer. It is worthy of clinical promotion and application.

Key words： Laparoscopy Pelvic autonomic nerve preservation Total mesorectal excision Rectal cancer

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	XU Yongshi LONG Yunzhi HU Keke

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XU Yongshi LONG Yunzhi HU Keke. Clinical effects of total mesorectal excision with pelvic autonomic nerve preservation by laparoscopy in male patients with middle and low rectal cancer[J]. 中国医药导报, 2018, 15(17): 98-101.

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http://www.yiyaodaobao.com.cn/EN/ OR http://www.yiyaodaobao.com.cn/EN/Y2018/V15/I17/98

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