title: Prognosis and postoperative genital function of function-preservative surgery of pelvic autonomic nerve preservation for male rectal cancer patients.
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.
authors.affiliation: Gastrointestinal Institute of Sun Yat-Sen University, Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-Sen University (Guangdong Gastrointestinal Hospital), 26 Yuancun Erheng Road, Guangzhou, Guangdong, 510655, People's Republic of China.
authors.forename: Zhihua
authors.initials: Z
authors.lastname: Liu
authors.affiliation: Gastrointestinal Institute of Sun Yat-Sen University, Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-Sen University (Guangdong Gastrointestinal Hospital), 26 Yuancun Erheng Road, Guangzhou, Guangdong, 510655, People's Republic of China.
authors.forename: Meijin
authors.initials: M
authors.lastname: Huang
authors.affiliation: Gastrointestinal Institute of Sun Yat-Sen University, Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-Sen University (Guangdong Gastrointestinal Hospital), 26 Yuancun Erheng Road, Guangzhou, Guangdong, 510655, People's Republic of China.
authors.forename: Liang
authors.initials: L
authors.lastname: Kang
authors.affiliation: Gastrointestinal Institute of Sun Yat-Sen University, Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-Sen University (Guangdong Gastrointestinal Hospital), 26 Yuancun Erheng Road, Guangzhou, Guangdong, 510655, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Wang
authors.affiliation: Gastrointestinal Institute of Sun Yat-Sen University, Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-Sen University (Guangdong Gastrointestinal Hospital), 26 Yuancun Erheng Road, Guangzhou, Guangdong, 510655, People's Republic of China.
authors.forename: Ping
authors.initials: P
authors.lastname: Lan
authors.affiliation: Department of Gastrointestinal Surgery, the First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China.
authors.forename: Ji
authors.initials: J
authors.lastname: Cui
authors.affiliation: Gastrointestinal Institute of Sun Yat-Sen University, Department of Colorectal Surgery, the Sixth Affiliated Hospital of Sun Yat-Sen University (Guangdong Gastrointestinal Hospital), 26 Yuancun Erheng Road, Guangzhou, Guangdong, 510655, People's Republic of China. j-p-wang@hotmail.com.
authors.forename: Jianping
authors.initials: J
authors.lastname: Wang
mesh_terms: D000328:Adult; D000368:Aged; D017776:Autonomic Pathways; D007172:Erectile Dysfunction / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology*; D010388:Pelvis / Q000294:innervation; D011183:Postoperative Complications; D011379:Prognosis; D012004:Rectal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Genital function; Pelvic autonomic nerve preservation; Rectal cancer; Survival rate; Total mesorectal excision