Sexual Function After Pelvic Autonomic Nerve Preservation Of Laparoscopic Radical Resection For Rectal In Male Patients

Rectal cancer is one of the common malignant tumors in China, the incidence ratewas increasing every year and getting younger and younger, and rectal cancer after5-year survival rate has been hovering around50%.The concept of the modern surgicaltreatment of rectal cancer is the most effective way is based on the combined therapy ofsurgery. In recent years, with a new introduction to the concept of the pelvic autonomicnerve preservation, total mesorectal excision and laparoscopic devices, applications,today’s treatment of laparoscopic rectal cancer surgery with the traditional open surgerywas no significant difference, and even better than traditional open surgery, and rectalcancer surgery to keep the anus chance to greatly improve.Low rectal cancer function(anal sphincter preservation and pelvic autonomic nerve preservation) surgical field hasalso made tremendous progress in a variety of insurance function technique has becomethe main technique. This study was to retain the male patients underwent laparoscopicpelvic autonomic nerve surgery and conventional open to retain the pelvic autonomicnerve surgery to explore the radical laparoscopic pelvic autonomic nerve preservationsurgery and the effect of postoperative functionObjective To evaluate the protection of sexual function after laparoscopic radicalresection with pelvic autonomic nerve preservation (PANP) for rectal cancer in malepatients．Methods Prospectively120male patients with middle or low rectal cancer receivingsurgery during September2008to August2010were divided into two groups(L-PANP，n=70；0-PANP，n=50). The radicalism and safety of L-PANP surgery were analyzed and the effects upon sexual function between the two groups assessed by erectile andejaculation function study．Results Patients receiving subtypes I and II of L-PANP surgery had bettersexual(erectile and ejaculation function) than those receiving the same subtype ofO-PANP surgery at the first period post-operation(Z=-2.207,P=0.027；Z=-2.207,P=0.027；Z=-2.203,P=0.042；Z=-2.226, P=0.026)．And no difference wasobserved in patients receiving subtypeⅢPANP surgery(Z=-1.656, P=0.095；Z=-1.163,P=0.245)．However，no matter which subtype of PANP surgery，patients of L-PANPgroup had no difference in those of O-PANP group at the second and the third periodpost-operation(P〉0.05)．The1-year survival rate was97.1％(68/70)in L-PANP groupand96.0％(48／50)in0-PANP group．And no statistical difference was found betweenthem(P=0.827)．Meanwhile，the1-year relapse rate of pelvic cavity wag4.3％(3/70)inL-PANP group and8.0％(4/50)in0-PANP group And no statistical difference wasfound between them(P=0.449)．Conclusion As compared with0-PANP surgery, L-PANP surgery without anyincrease in relapse rate of pelvic cavity, shows a superiority in protection of malesexual function and improves patient serial from quality.