Nerve-sparing surgery with lateral node dissection for advanced lower rectal cancer.
133 patients who underwent nerve-sparing surgery with lateral dissection for lower rectal cancer were analysed for survival and functional results, operative burdens, and modes of recurrence. In 84% of patients an acceptable urinary function was preserved. Operative time averaged 334 min, and blood loss averaged 935 ml. The 5-year survival rate was 67% in all patients, and 88% for Dukes' A, 74% for Dukes' B and 59% for Dukes' C. According to the number of positive nodes, the 5-year survival rate comprised 83% of patients with up to three nodes, and 34% of those with more than four nodes. Local recurrent rates were 2.7% in patients with Dukes' B and 13% with Dukes' C. At present, pelvic nerve-sparing procedures with lateral dissection is the most promising surgery, guaranteeing both adequate lymphadenectomy and preservation of urinary function.
Moriya
Y
Y
Department of Surgery, National Cancer Center, Tokyo, Japan.
Sugihara
K
K
Akasu
T
T
Fujita
S
S
D017776:Autonomic Pathways; D016063:Blood Loss, Surgical; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007432:Intraoperative Period; D008197:Lymph Node Excision / Q000009:adverse effects / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D012004:Rectal Neoplasms / Q000401:mortality / Q000601:surgery*; D012735:Sexual Dysfunction, Physiological / Q000209:etiology; D014555:Urination Disorders / Q000209:etiology