Function preservation in rectal cancer surgery.
Function preservation in rectal cancer surgery.
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DOI：
10.1007/s10147-006-0608-z
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发表时间：
2006-10-01
影响因子：
3.3
通讯作者：
Moriya, Yoshihiro
中科院分区：
文献类型：
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作者：
Moriya, Yoshihiro
当全直肠系膜切除术（TME）是准确执行，功能障碍，理论上，不会发生。然而，在跑步模式和神经纤维的体积方面存在个体差异，如果存在肥胖或骨盆狭窄，则神经识别是困难的。目前，直肠手术后排尿功能障碍的发生率为33%至70%。除神经保留外，许多因素在轻度尿失禁中起作用。男性性功能显示阳痿率从20%到46%不等，而20%-60%的阳痿患者无法射精。在女性中，关于性功能的信息不容易获得，并且比男性有更多的未知方面。据报道，由于辅助放疗引起的泌尿、性和排便功能障碍发生率很高，因此制定一项能够分析长期功能结局的方案对未来的临床试验至关重要。在直肠癌的治疗中，与外科医生相关的因素非常重要，不仅在实现局部控制方面，而且在保留功能方面。本文综述了近年来直肠癌手术后排尿、性功能和排便功能障碍的研究结果，并讨论了今后需要研究的问题。
When total mesorectal excision (TME) is accurately performed, dysfunction, theoretically, does not occur. However, there are differences among individuals in the running patterns and the volumes of nerve fibers, and if obesity or a narrow pelvis is present, nerve identification is difficult. Currently, the rate of urinary dysfunction after rectal surgery ranges from 33% to 70%. Many factors other than nerve preservation play a role in minor incontinence. Male sexual function shows impotence rates ranging from 20% to 46%, while 20%-60% of potent patients are unable to ejaculate. In women, information on sexual function is not easily obtained, and there are more unknown aspects than in men. As urinary, sexual, and defecation dysfunction due to adjuvant radiotherapy have been reported to occur at a high frequency, the creation of a protocol that enables analysis of long-term functional outcome will be essential for future clinical trials. In the treatment of rectal cancer, surgeon-related factors are extremely important, not only in achieving local control but also in preserving function. This article reviews findings from recent studies investigating urinary, sexual, and defecation dysfunction after rectal cancer surgery and discusses questions to be studied in the future.