摘要
目的探讨直肠癌根治性手术中保留植物性神经术后病人排尿、性功能的状况。方法依据进展程度,对1992年1月至2002年1月实施根治性手术的560例直肠癌进行回顾性分析,其中完全保留神经者408例,保留一侧或部分神经者50例,非保留神经者102例。结果完全保留神经者93.5%排尿功能正常,保留一侧或部分神经者63.6%为正常,非保留神经者仅29.5%为正常。完全神经保留者100%勃起功能良好、85.5%射精功能良好、14.5%有逆精现象。一侧或部分神经保留者,90%勃起功能良好,52.5%的射精功能良好,38.2%有逆精现象。局部复发率10.2%(57/560),5年存活率74.1%(417/560);完全神经保留组分别为6.2%、82.4%,一侧或部分神经保留组为13.3%、68.8%,非保留神经组为24.5%,45.5%。结论保留植物性神经的直肠癌根治术,在确保根治性原则的同时,可良好地保存排尿及性功能。
Objective To investigate efficiency of potentially-cure surgery with autonomic nerves preservation for rectal cancer, and its effects on urinary and sexual functions. Methods The clinical data of 560 male cases with rectal cases performed by radical resection from January 1992 to January 2002 were retrospectively reviewed. Among them, the autonomic nerves of 408 cases were fully preserved, with 50 cases laterally or partly preserved, and 102 cases totally sacririced. Results The urinary function in 93.5% of cases with autonomic nerves spare surgery, in 63. 6% of cases with laterally or partly nerve preservation surgery and 29. 5% of cases with nerve sacrifice surgery were well preserved. In 408 cases operated with fully nerve spare surgery ,408 cases had normal erection ,and 59 cases （85.5%） had fine ejaculation, and 59 cases （ 14.5% ） experienced sperm reflux. In 50 cases with partly nerve preservation surgery, the rate was 90% （45/50） ,52.5% （26/50） ,and 38. 2% （19/50） respectively. While in 102 cases with nerve sacrifice surgery,none had normal erection or ejaculatory function. The total local relapse rate in the study was 10.2%, and the 5-year survival rate was 74. 1%. The local recurrence rate and 5-year survival rate in fully nerves spare group was 10.2% and 74. 1% ,in partly nerve preservation group was 13. 3% and 68.8% ,and in nerves sacrifice group was 24. 5% and 45. 5% ,respectively. Conclusion For rectal cancer patients, the radical surgery with autonomic nerves preservation ensures the fine the urinary and sexual functions.
出处
《中国实用外科杂志》
CSCD
北大核心
2006年第11期843-846,共4页
Chinese Journal of Practical Surgery
关键词
直肠癌根治术
植物性神经
Rectal cancer radical surgery
Autonomic nerves
