Gökçe Aylin Hande, Özkan Hakan
İstanbul Medicine Hastanesi, Genel Cerrahi Kliniği, İstanbul, Türkiye.
Star Medica Hastanesi, Genel Cerrahi Kliniği, Tekirdağ, Türkiye.
Turk J Surg. 2019 Dec 16;35(4):293-298. doi: 10.5578/turkjsurg.4397. eCollection 2019 Dec.
Erectile dysfunction may occur as a complication of surgical treatment of rectal cancer in male patients. We compared the rates of postoperative erectile dysfunction and response to medical treatment after low anterior resection (LAR) and Miles' procedures.
Fifty patients who underwent the Miles' procedure or LAR were prospectively assessed. This study includes fifty patients with stages 1 and stage 2 rectal cancer based on clinical and radiologic assessments, who underwent Miles' (25 out of 50 patients underwent the Miles'procedure and ) or LAR (25 patients underwent LAR) procedures were prospectively assessed. The International Index of Erectile Function (IIEF) form was, used in the assessment to assess erectile dysfunction. This questionnaire, was administered preoperatively and 6 months postoperatively. For the patients with IIEF scores ≤ 25 at postoperative 6th months, tadalafil 5 mg is was given for 12 weeks and IIEF is was repeated after then.
No significant differences were found in mean IIEF scores preoperatively (p= 0.695). In both groups, IIEF scores were significantly lower postoperatively compared with preoperatively (p= 0.00001, LAR; p= 0.00001, Miles'). Mean postoperative IIEF scores were significantly lower in patients who underwent Miles' compared with the LAR procedures (p= 0.0001). For patients with IIEF scores ≤ 25 at 6 months, tadalafil 5 mg was given for 12 weeks and IIEF scores were better in both groups (p= 0.00001).
The erectile dysfunction rate after Miles' procedure was significantly higher than the rate of patients who developed erectile dysfunction after LAR surgery. We tried to emphasize that in after LAR surgery. We should not be concerned only with cancer treatment surgically in rectal tumour patients, but remember that situations affecting their social life, such as postoperative erectile dysfunction, have medical and psychologic importance.
男性直肠癌患者手术治疗后可能出现勃起功能障碍。我们比较了低位前切除术（LAR）和Miles手术术后勃起功能障碍的发生率及药物治疗反应。
对50例行Miles手术或LAR的患者进行前瞻性评估。本研究纳入50例根据临床和影像学评估为1期和2期直肠癌的患者，其中25例行Miles手术（50例患者中有25例接受Miles手术），25例行LAR手术，对这些患者进行前瞻性评估。采用国际勃起功能指数（IIEF）表格评估勃起功能障碍。该问卷在术前和术后6个月发放。术后6个月IIEF评分≤25分的患者给予他达拉非5mg，持续12周，之后再次进行IIEF评估。
术前平均IIEF评分无显著差异（p = 0.695）。两组术后IIEF评分均显著低于术前（LAR组，p = 0.00001；Miles组，p = 0.00001）。行Miles手术患者的术后平均IIEF评分显著低于行LAR手术的患者（p = 0.0001）。术后6个月IIEF评分≤25分的患者给予他达拉非5mg治疗12周后，两组IIEF评分均有所改善（p = 0.00001）。
Miles手术后勃起功能障碍的发生率显著高于LAR手术后勃起功能障碍的发生率。我们试图强调，在LAR手术后，对于直肠肿瘤患者，我们不应仅关注手术癌症治疗，还应记住影响他们社交生活的情况，如术后勃起功能障碍，具有医学和心理重要性。
