Laparoscopic Pelvic Autonomic Nerve-Preserving Surgery for Sigmoid Colon Cancer_West China Medical Journal

Authors：

WU Miao , YANG Jian , LIU Jian , DENG Xiaodong , ZHENG Tao , LIU Shicheng , CHEN Liheng .

The Second People’s Hospital of Yibin, Yibin, Sichuan 644000, P. R. China;

Corresponding?author：

Keywords：

腹腔鏡; 乙狀結腸癌; 盆腔自主神經

DOI：

10.7507/1002-0179.20130316

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目的　探討腹腔鏡下乙狀結腸癌根治術保留盆腔自主神經的可行性及對術后泌尿、生殖功能的影響。方法　選取2007年8月－2009年7月60例行腹腔鏡下乙狀結腸癌根治術患者，手術按標準腹腔鏡下乙狀結腸癌前切除手術方式操作。術后采用問卷調查方式對患者術后泌尿功能、男性勃起功能、女性性功能進行效果評價。生殖泌尿功能評估包含國際前列腺增生評分（IPSS）、國際勃起功能評分量表（IIEF）、女性性功能評估量表（FSFI）。結果　58例患者成功保留自主神經，56例接受術后泌尿、生殖功能測定，置放尿管時間為1～7 d，平均3 d，拔除尿管后排尿功能良好（IPSS 0～7分）57例（95.0%），一般（IPSS 8～14分）2例（3.3%），差（IPSS 15～35分）1例（1.7%），術前、術后IPSS評分差異無統計學意義（P=0.075）。30例男性患者術后，射精良好27例（90.0%），一般2例（6.7%），差1例（3.3%）；但是勃起功能測定良好（IIEF 60～75分）28例（93.4%），一般（IIEF 44～59分）1例（3.3%），差（IIEF 5～43分）1例（3.3%），術前、術后IIEF差異無統計學意義。26例女性患者術后性功能評分，良好（FSFI 76～95分） 23例（88.5%），一般（FSFI 58～75分） 2例（7.7%），差（FSFI 4～57分）1例（3.8%）。盆腔神經保留成功的患者術前、術后差異無統計學意義（P=0.122）。結論　多數腹腔鏡下乙狀結腸癌根治術患者能有效保留盆腔自主神經，且術后能保留泌尿、生殖功能。

Citation： WU Miao,YANG Jian,LIU Jian,DENG Xiaodong,ZHENG Tao,LIU Shicheng,CHEN Liheng .. Laparoscopic Pelvic Autonomic Nerve-Preserving Surgery for Sigmoid Colon Cancer. West China Medical Journal, 2013, 28(7): 1021-1024. doi: 10.7507/1002-0179.20130316 Copy

1.	Hendren SK, O’Connor BI, Liu M, et al. Prevalence of male and female sexual dysfunction is high following surgery for rectal cancer[J]. Ann Surg, 2005, 242(2): 212-223.
2.	Matsumoto T, Ohue M, Sekimoto M, et al. Feasibility of autonomic nerve-preserving surgery for advanced rectal cancer based on analysis of micrometastases[J]. Br J Surg, 2005, 92(11): 1444-1448.
3.	Shirouzu K, Ogata Y, Araki Y. Oncologic and functional results of total mesorectal excision and autonomic nerve-preserving operation for advanced lower rectal cancer[J]. Dis Colon Rectum, 2004, 47(9): 1442-1447.
4.	Sugihara K, Moriya Y, Akasu T, et al. Pelvic autonomic nerve preservation for patients with rectal carcinoma. Oncologic and functional outcome[J]. Cancer, 1996, 78(9): 1871-1880.
5.	Kim NK, Aahn TW, Park JK, et al. Assessment of sexual and voiding function after total mesorectal excision with pelvic autonomic nerve preservation in males with rectal cancer[J]. Dis Colon Rectum, 2002, 45(9): 1178-1185.
6.	Moriya Y. Function preservation in rectal cancer surgery[J]. Int J Clin Oncol, 2006, 11(5): 339-343.
7.	Platell CF, Thompson PJ, Makin GB. Sexual health in women following pelvic surgery for rectal cancer[J]. Br J Surg, 2004, 91(4): 465-468.
8.	Liang JT, Lai HS, Lee PH. Laparoscopic pelvic autonomic nerve-preserving surgery for patients with lower rectal cancer after chemoradiation therapy[J]. Ann Surg Oncol, 2007, 14(4): 1285-1287.
9.	Liang JT, Chang KJ, Wang SM. Anatomical basis of autonomic nerve-preserving total mesorectal excision for rectal cancer[J]. Br J Surg, 1997, 84(4): 586-587.
10.	Liang JT, Chien CT, Chang KJ, et al. Neurophysiological basis of sympathetic nerve-preserving surgery for lower rectal cancer-a canine model[J]. Hepatogastroenterology, 1998, 45(24): 2206-2214.
11.	Walsh PC, Schlegel PN. Radical pelvic surgery with preservation of sexual function[J]. Ann Surg, 1988, 208(4): 391-400.
12.	Jayne DG, Brown JM, Thorpe H, et al. Bladder and sexual function following resection for rectal cancer in a randomized clinical trial of laparoscopic versus open technique[J]. Br J Surg, 2005, 92(9): 1124-1132.
13.	牟一平, 楊鵬, 嚴加費, 等. 腹腔鏡結腸癌根治術的臨床療效評估[J]. 中華外科雜志, 2006, 44(9): 581-583.
14.	譚敏, 郭寶賢, 吳志棉, 等. 經腹腔鏡結直腸癌切除術[J]. 中華外科雜志, 2002, 40(10): 769-772.
15.	王秋生. 腹腔鏡胃腸外科[J]. 腹腔鏡外科雜志, 2002, 7(1): 1.
16.	Rosen RC, Riley A, Wagner G, et al. The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction[J]. Urology, 1997, 49(6): 822-830.
17.	Rosen R, Brown C, Heiman J, et al. The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function[J]. J Sex Marital Ther, 2000, 26(2): 191-208.
18.	顧晉, 馬朝來, 夏家騮, 等. 直腸癌根治術中保留骨盆自主神經的神經解剖學基礎及臨床意義[J]. 中華外科雜志, 2000, 38(2): 128-130.
19.	趙沨, 施培友. 直腸癌TME 術中保留盆腔自主神經對男性性功能及排尿功能的影響[J]. 中國普外基礎與臨床雜志, 2011, 18(2): 191-195.
20.	魯發龍, 杜剛毅, 鄭少康, 等. 直腸癌根治術保留自主神經56例臨床體會[J]. 結直腸肛門外科, 2009, 15(2): 83-84.
21.	顧晉, 李學松. 保留盆腔自主神經的直腸癌手術對男性排尿及性功能的影響[J]. 中華胃腸外科雜志, 2001, 4(2): 126-128.
22.	楊映弘, 顏璟, 藺原, 等. 腹腔鏡全直腸系膜切除術盆腔自主神經保留對術后性功能的影響[J]. 中國普外基礎與臨床雜志, 2008, 15(10): 726-727.
23.	Saito N, Koda K, Nobuhiro K, et al. Nerve-sparing surgery for advanced rectal cancer patients: special reference to Dukes C patients[J]. World J Surg, 1999, 23(10): 1062-1068.
24.	梁德森, 姜濤, 張鐵民, 等. 直腸癌手術中保留盆腔自主神經的意義[J]. 中華普通外科雜志, 2006, 21(7): 511-513.

1. 　Hendren SK, O’Connor BI, Liu M, et al. Prevalence of male and female sexual dysfunction is high following surgery for rectal cancer[J]. Ann Surg, 2005, 242(2): 212-223.
2. 　Matsumoto T, Ohue M, Sekimoto M, et al. Feasibility of autonomic nerve-preserving surgery for advanced rectal cancer based on analysis of micrometastases[J]. Br J Surg, 2005, 92(11): 1444-1448.
3. 　Shirouzu K, Ogata Y, Araki Y. Oncologic and functional results of total mesorectal excision and autonomic nerve-preserving operation for advanced lower rectal cancer[J]. Dis Colon Rectum, 2004, 47(9): 1442-1447.
4. 　Sugihara K, Moriya Y, Akasu T, et al. Pelvic autonomic nerve preservation for patients with rectal carcinoma. Oncologic and functional outcome[J]. Cancer, 1996, 78(9): 1871-1880.
5. 　Kim NK, Aahn TW, Park JK, et al. Assessment of sexual and voiding function after total mesorectal excision with pelvic autonomic nerve preservation in males with rectal cancer[J]. Dis Colon Rectum, 2002, 45(9): 1178-1185.
6. 　Moriya Y. Function preservation in rectal cancer surgery[J]. Int J Clin Oncol, 2006, 11(5): 339-343.
7. 　Platell CF, Thompson PJ, Makin GB. Sexual health in women following pelvic surgery for rectal cancer[J]. Br J Surg, 2004, 91(4): 465-468.
8. 　Liang JT, Lai HS, Lee PH. Laparoscopic pelvic autonomic nerve-preserving surgery for patients with lower rectal cancer after chemoradiation therapy[J]. Ann Surg Oncol, 2007, 14(4): 1285-1287.
9. 　Liang JT, Chang KJ, Wang SM. Anatomical basis of autonomic nerve-preserving total mesorectal excision for rectal cancer[J]. Br J Surg, 1997, 84(4): 586-587.
10. 　Liang JT, Chien CT, Chang KJ, et al. Neurophysiological basis of sympathetic nerve-preserving surgery for lower rectal cancer-a canine model[J]. Hepatogastroenterology, 1998, 45(24): 2206-2214.
11. 　Walsh PC, Schlegel PN. Radical pelvic surgery with preservation of sexual function[J]. Ann Surg, 1988, 208(4): 391-400.
12. 　Jayne DG, Brown JM, Thorpe H, et al. Bladder and sexual function following resection for rectal cancer in a randomized clinical trial of laparoscopic versus open technique[J]. Br J Surg, 2005, 92(9): 1124-1132.
13. 　牟一平, 楊鵬, 嚴加費, 等. 腹腔鏡結腸癌根治術的臨床療效評估[J]. 中華外科雜志, 2006, 44(9): 581-583.
14. 　譚敏, 郭寶賢, 吳志棉, 等. 經腹腔鏡結直腸癌切除術[J]. 中華外科雜志, 2002, 40(10): 769-772.
15. 　王秋生. 腹腔鏡胃腸外科[J]. 腹腔鏡外科雜志, 2002, 7(1): 1.
16. 　Rosen RC, Riley A, Wagner G, et al. The International Index of Erectile Function (IIEF): a multidimensional scale for assessment of erectile dysfunction[J]. Urology, 1997, 49(6): 822-830.
17. 　Rosen R, Brown C, Heiman J, et al. The female sexual function index (FSFI): a multidimensional self-report instrument for the assessment of female sexual function[J]. J Sex Marital Ther, 2000, 26(2): 191-208.
18. 　顧晉, 馬朝來, 夏家騮, 等. 直腸癌根治術中保留骨盆自主神經的神經解剖學基礎及臨床意義[J]. 中華外科雜志, 2000, 38(2): 128-130.
19. 　趙沨, 施培友. 直腸癌TME 術中保留盆腔自主神經對男性性功能及排尿功能的影響[J]. 中國普外基礎與臨床雜志, 2011, 18(2): 191-195.
20. 　魯發龍, 杜剛毅, 鄭少康, 等. 直腸癌根治術保留自主神經56例臨床體會[J]. 結直腸肛門外科, 2009, 15(2): 83-84.
21. 　顧晉, 李學松. 保留盆腔自主神經的直腸癌手術對男性排尿及性功能的影響[J]. 中華胃腸外科雜志, 2001, 4(2): 126-128.
22. 　楊映弘, 顏璟, 藺原, 等. 腹腔鏡全直腸系膜切除術盆腔自主神經保留對術后性功能的影響[J]. 中國普外基礎與臨床雜志, 2008, 15(10): 726-727.
23. 　Saito N, Koda K, Nobuhiro K, et al. Nerve-sparing surgery for advanced rectal cancer patients: special reference to Dukes C patients[J]. World J Surg, 1999, 23(10): 1062-1068.
24. 　梁德森, 姜濤, 張鐵民, 等. 直腸癌手術中保留盆腔自主神經的意義[J]. 中華普通外科雜志, 2006, 21(7): 511-513.

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