Autonomic Nerve Preserving Operation for Rectal Cancer

对167例直肠癌施行保留盆腔自主神经的新术式。该手术旨在避免术后排尿和性功能障碍，而不干扰癌症根治的根治。术中明确辨认腹下神经、盆丛和盆腔脾神经(竖直神经)，切除伴有区域淋巴结的癌组织。术后5年累计生存率为72.7%，与常规手术相比，局部复发率无明显增加。术后排尿功能障碍发生率为13.8%，6个月后全部缓解。活动期男性术后性功能障碍的发生率仅为21%。此外，在许多情况下，不仅完全保留神经，而且单侧或部分保留神经也能避免排尿和性功能障碍。

A new operation preserving pelvic autonomic nerve for rectal cancer was done in 167 cses. The operation is intended to avoid postoperative urinary and sexual dysfunction without interference with the radicality for cure of cancer. In the operative procedure, the hypogastric nerves, pelvic plexus and pelvic splancnic nerves ( nervi erigentes ) were identified clealy and left intach, while the cancer bearing with regional lymphnodes were totally removed. The postoperative 5 year cumulative survival rate was 72.7 % and there has been no definite increase of local recurrence co,pared with the patients after the usual operations. The postoperative urinary dysfunction was observed in 13.8 % of the patients and all was relieved after 6 months. The postoperative sexual dysfunction in active males was observed only in 21 % . Furthrtmore, not only total but unilateral or partial preservation of the nerves was also capable to avoid the urinary and sexual dysfunction in many cases.