Zheng Zong-heng, Wei Hong-bo, Chen Tu-feng, Huang Jiang-long, Wei Bo, Hu Bao-guang, Zheng Feng, Guo Wei-ping, Huang Yong, Situ Jie
Department of Gastrointestinal Surgery, Third Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
Zhonghua Yi Xue Za Zhi. 2009 Nov 17;89(42):2976-9.
To evaluate the protection of urinary function after laparoscopic radical resection with pelvic autonomic nerve preservation (PANP) for rectal cancer.
Prospectively 139 patients with middle or low rectal cancer receiving surgery during November 2005 to October 2007 were divided into two groups (L-PANP, n = 63; O-PANP, n = 76). The radicalism and safety of L-PANP surgery were analyzed and the effects upon urinary function between the two groups assessed by follow-ups and urodynamic study.
Patients receiving subtypes I and II of L-PANP surgery had less decrease in contraction of bladder than those receiving the same subtype of O-PANP surgery at 10 days post-operation (Z = -2.358, P = 0.018; Z = -2.268, P = 0.033). And no difference was observed in patients receiving subtype III PANP surgery (Z = -1.302, P = 0.237). However, no matter which subtype of PANP surgery, patients of L-PANP group had a better contraction of bladder than those of O-PANP group at 1 month post-operation (P < 0.05). The 1-year survival rate was 98.0% (50/51) in L-PANP group and 96.6% (57/59) in O-PANP group. And no statistical difference was found between them (P = 0.898). Meanwhile, the 1-year relapse rate of pelvic cavity was 3.9% (2/52) in L-PANP group and 5.1% (3/59) in O-PANP group. And no statistical difference was found between them (P = 0.867).
As compared with O-PANP surgery, L-PANP surgery shows a superiority in protection of urinary function.
评估腹腔镜直肠癌根治术保留盆腔自主神经（PANP）对泌尿功能的保护作用。
前瞻性选取2005年11月至2007年10月期间接受手术的139例中低位直肠癌患者，分为两组（L-PANP组，n = 63；O-PANP组，n = 76）。分析L-PANP手术的根治性和安全性，并通过随访和尿动力学研究评估两组对泌尿功能的影响。
接受I型和II型L-PANP手术的患者术后10天膀胱收缩功能下降程度低于接受相同亚型O-PANP手术的患者（Z = -2.358，P = 0.018；Z = -2.268，P = 0.033）。接受III型PANP手术的患者未观察到差异（Z = -1.302，P = 0.237）。然而，无论PANP手术的哪种亚型，L-PANP组患者术后1个月的膀胱收缩功能均优于O-PANP组（P < 0.05）。L-PANP组1年生存率为98.0%（50/51），O-PANP组为96.6%（57/59）。两组间无统计学差异（P = 0.898）。同时，L-PANP组盆腔1年复发率为3.9%（2/52），O-PANP组为5.1%（3/59）。两组间无统计学差异（P = 0.867）。
与O-PANP手术相比，L-PANP手术在保护泌尿功能方面具有优势。
