The Value Of Follow The Pelvic Autonomic Nerve Plexus Protection In Laparoscopic Rectal Carcinoma Radical Surgery

Objective: The study was aimed to assess the differences of the strictly follow plexus protection(experimental group),and not strictly follow the plexus protection(controlled group)in laparoscopic rectal carcinoma radical surgery,all the cases are middle-lower rectal carcinom without pelvic wall invasion and lymph node metastasis which should obey the TME principle,and the pelvic autonomic nerve plexus can be protected.We especially compared the completion of TME,intraoperative cleaning the number of lymph,the plexus injury and postoperative sexual function and urinary function,so as to explore the value of follow the pelvic autonomic nerve plexus protection in laparoscopic rectal carcinoma radical surgery,and proving the importance and significance of follow the pelvic autonomic nerve plexus protection in laparoscopic rectal carcinoma radical surgery.Methods : A prospective cohort study of the 99 cases of our hospital gastrointestinal surgery from September2013 to September 2015.All the patients were whom hospitalized because of middle-lower rectal carcinom.The patients were randomly divided into " strictly follow plexus protection group " and "not strictly follow plexus protection group" in which "strictly follow plexus protection group" 53 cases,"not strictlyfollow plexus protection group" 46 cases.The operation time,intraoperative blood loss,postoperative hospital stay and the incidence of postoperative complications(anastomotic fistula,anastomotic bleeding,intestinal anastomotic stricture,infection of incision,pulmonary infection,adhesion sex intestinal obstruction),completion of TME,intraoperative cleaning the number of lymph,plexus injury rate,postoperative incidence of micturition,sexual dysfunction,and the one year of carcinoma postoperative local recurrence rate and one year of postoperative survival rate were compared.All the data from this study was analysised by SPSS17.0 and Excel2003.According to the data types to choose reasonable statistical method,inspection level alpha value is 0.05.Results: The removal of intestinal canal length,postoperative hospital stay and the incidence of postoperative complications of the two groups was no statistically significant difference(P>0.05).experimental group’s intraoperative blood loss is less than controlled group,and the difference between the two groups was statistically significant(P <0.05).For the completion of TME,and intraoperative cleaning the number of lymph,experimental group are higher than controlled group,the difference between the two groups was statistically significant(P <0.05).The results showed that the experimental group’s postoperative urinary function and sexual dysfunction was significantly lower than controlled group,the difference between the two groups was statistically significant(P<0.05).The operation time of experimental group is longer than controlled group,the difference between the two groups was statistically significant(P <0.05).Conclusions:Strictly follow the pelvic autonomic nerve plexus protection in laparoscopic rectal carcinoma radical surgery can improve the completion of TME,and increase intraoperative cleaning the number of lymph,and it can reduce the damage to the pelvic autonomic nerves so as to reduce the incidence of micturition and sexual dysfunction.And,strictly follow the pelvic autonomic nerve plexus protection in laparoscopic rectal carcinoma radical surgery will not increase the incidence of postoperative complications and short-term rectal cancer local recurrence rate.