Hypogastric nerve preservation does not increase local recurrence after surgical treatment of rectal carcinoma.
OBJECTIVE
The main aim of the study was to evaluate whether superior hypogastric plexus and hypogastric nerve can be preserved without increasing local recurrence while performing surgical treatment of rectal carcinoma.


METHODS
This was a retrospective study of 129 patients with rectal carcinoma who underwent curative resection with two types of autonomic nerve-sparing operation. The superior hypogastric plexus and bilateral hypogastric nerves were resected in 61 patients and spared in 68 patients. The pelvic plexus was preserved in all the patients. Local recurrence and survival were compared between two operations.


RESULTS
After three years, local recurrence cumulative rates were 13.1% after hypogastric nerve removing operation and 10.3% after hypogastric nerve preserving operation. Distant metastasis and corrected 5-year survival rates were 23.0 and 61.6%, respectively after hypogastric nerve-removing operation, while after hypogastric nerve-preserving operation those were 16.2 and 77.4%, respectively. There were no statistically significant differences in local recurrence, distant metastasis and survival between the two groups.


CONCLUSIONS
Hypogastric nerve-preserving operation does not appear to carry an increased risk of local recurrence compared with hypogastric nerve-removing operation after an equivalent follow-up period.
Tsunoda
Akira
A
Second Department of Surgery, School of Medicine, Showa University, Tokyo, Japan.
Shibusawa
Miki
M
Tanizaki
Hirotoshi
H
Kusano
Mitsuo
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007001:Hypogastric Plexus / Q000473:pathology / Q000601:surgery*; D007564:Japan; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D009367:Neoplasm Staging; D012004:Rectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D012007:Rectum / Q000473:pathology / Q000601:surgery; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed