[Urinary function after pelvic autonomic nerve preservation of laparoscopic radical resection for rectal cancer].
OBJECTIVE
To evaluate the protection of urinary function after laparoscopic radical resection with pelvic autonomic nerve preservation (PANP) for rectal cancer.


METHODS
Prospectively 139 patients with middle or low rectal cancer receiving surgery during November 2005 to October 2007 were divided into two groups (L-PANP, n = 63; O-PANP, n = 76). The radicalism and safety of L-PANP surgery were analyzed and the effects upon urinary function between the two groups assessed by follow-ups and urodynamic study.


RESULTS
Patients receiving subtypes I and II of L-PANP surgery had less decrease in contraction of bladder than those receiving the same subtype of O-PANP surgery at 10 days post-operation (Z = -2.358, P = 0.018; Z = -2.268, P = 0.033). And no difference was observed in patients receiving subtype III PANP surgery (Z = -1.302, P = 0.237). However, no matter which subtype of PANP surgery, patients of L-PANP group had a better contraction of bladder than those of O-PANP group at 1 month post-operation (P < 0.05). The 1-year survival rate was 98.0% (50/51) in L-PANP group and 96.6% (57/59) in O-PANP group. And no statistical difference was found between them (P = 0.898). Meanwhile, the 1-year relapse rate of pelvic cavity was 3.9% (2/52) in L-PANP group and 5.1% (3/59) in O-PANP group. And no statistical difference was found between them (P = 0.867).


CONCLUSIONS
As compared with O-PANP surgery, L-PANP surgery shows a superiority in protection of urinary function.
Department of Gastrointestinal Surgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Zong-heng
ZH
Zheng
Hong-bo
HB
Wei
Tu-feng
TF
Chen
Jiang-long
JL
Huang
Bo
B
Wei
Bao-guang
BG
Hu
Feng
F
Zheng
Wei-ping
WP
Guo
Yong
Y
Huang
Jie
J
Situ
D000328:Adult; D017776:Autonomic Pathways / Q000502:physiology*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D019635:Neurosurgical Procedures / Q000379:methods; D010388:Pelvis / Q000294:innervation*; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000503:physiopathology / Q000601:surgery*; D020196:Trauma, Nervous System / Q000517:prevention & control*; D014555:Urination Disorders / Q000517:prevention & control; D014563:Urodynamics