[Nerve sparing total mesorectal excision for rectal cancer. Technical notes and results].

OBJECTIVE

To evaluate the quality of life after nerve sparing total mesorectal excision for rectal cancer.

PATIENTS AND METHODS

Crucial technical aspects of the procedure such as the preservation of genitourinary innervation and the achievement of optimal local control of the disease have been emphasized. It is known that local recurrences, sexual and urinary dysfunctions may have a significant impact on postoperative quality of life of the patients. Postoperative evaluation of functional outcomes of nerve sparing total mesorectal excision has been carried out utilizing the QLQ C30 (version 3) (All CR38).

RESULTS

At one year follow-up 27.2% of the patients presented sexual activity related dysfunctions, 6.1% complained of urinary dysfunction and 21% of the patients complained of some significant psychologic disturbances.

CONCLUSIONS

A correct surgical dissection with preservation of inferior hypogastric plexus and all genitourinary nerve supply yield the best results either in terms of quality of life and of oncologic control of the disease.