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01.12.2016 | Research article | Ausgabe 1/2016 Open Access

BMC Surgery 1/2016

Prognosis and postoperative genital function of function-preservative surgery of pelvic autonomic nerve preservation for male rectal cancer patients

Zeitschrift:
BMC Surgery > Ausgabe 1/2016
Autoren:
Zhihua Liu, Meijin Huang, Liang Kang, Lei Wang, Ping Lan, Ji Cui, Jianping Wang
Wichtige Hinweise

Competing interests

The authors declare that they have no conflict of interest.

Authors’ contribution

Z L and J Wang designed the study. Z L wrote the original manuscript, and edited all subsequent versions, performed the study except following referred. L K and M H performed the surgery, and revised the manuscript. L W and P L performed the statistical analysis. L W and J W revised the manuscript, and check the data. P L and J C performed the screening and intervention of subjects. All authors approved the final version.

Abstract

Background

To retrospectively evaluate postoperative genital function, local recurrence rate and survival rate after total mesorectal excision (TME) combined with or without pelvic autonomic nerve preservation (PANP) in male patients with rectal cancer.

Methods

A total of 953 male patients with rectal cancer after TME (518 patients received TME combined with PANP [PANP group] and 434patients received TME alone [TME group]) were included. Assessments of postoperative genital function, local recurrence rate, and 5 year survival rate were collected.

Results

Rate of erection dysfunction in PANP group (41.9 %) was significantly lower than that in TME group (76.7 %, P < 0.05). Rate of ejaculation dysfunction in PANP group (42.5 %) was also significantly lower than that in TME group (67.3 %, P < 0.05). Local recurrence rate (P = 0.66) and survival rate (P = 0.26) did not differ between the two groups. For patients with preoperative obstruction, local recurrence rate was significantly higher (P = 0.01) and survival rate significantly lower (P = 0.03) in PANP group.

Conclusions

PANP surgery has significant advantage with respect to preservation of genital function and should be recommended as surgical treatment for rectal cancer patients. However, PANP surgery should be considered with caution in patients with preoperative obstruction in view of the poorer long-term outcomes in these patients.
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