Department of Urology, Aarhus University Hospital, Aarhus, Denmark.
Department of Surgery, Aarhus University Hospital, Aarhus, Denmark.
Colorectal Dis. 2021 Feb;23(2):367-375. doi: 10.1111/codi.15482. Epub 2021 Feb 2.
The aim of this work was to determine the knowledge gap in the field of erectile function (EF) after colorectal cancer surgery and investigate and compare long-term male EF in colon and rectal cancer survivors in a national population.
Danish male patients alive without evidence of recurrence who were treated for colon or rectal cancer between May 2001 and December 2014 were invited to participate. Using the International Index of Erectile Function (IIEF) score the derived dichotomized erectile dysfunction (ED) was defined as moderate/severe or no/mild. Patients were grouped based on type of surgery [colon resection, rectal resection (RR) or local resection] and stratified for stoma, preoperative radiotherapy (RT), age and American Society of Anesthesiologists (ASA) score.
Of 10 037 eligible patients, 4334 responded (43.18%). The EF score was significantly lower for RR (mean 12.14) compared with both colon resection (mean 15.82) and local resection (mean 14.81) (p < 0.0001). No significant difference between colon resection and local resection was found (p = 0.29). Both a stoma and the use of RT were independent risk factors for ED. After excluding patients with stoma and RT and adjusting for age and ASA score, RR still had a higher risk of ED (OR 1.42, CI 1.20-1.67) compared with colon resection.
RR has a negative affect on EF. No difference between patients who underwent colon resection and local resection was found. RT and stoma were independent risk factors for ED.
本研究旨在确定结直肠癌手术后勃起功能（EF）领域的知识空白，并调查和比较全国范围内结肠癌和直肠癌幸存者的长期男性 EF。
邀请丹麦男性患者在 2001 年 5 月至 2014 年 12 月期间接受结肠癌或直肠癌治疗后，在无复发证据的情况下存活，参加研究。采用国际勃起功能指数（IIEF）评分，将获得的勃起功能障碍（ED）分为中度/重度或无/轻度。根据手术类型[结肠切除术、直肠切除术（RR）或局部切除术]对患者进行分组，并根据造口、术前放疗（RT）、年龄和美国麻醉师协会（ASA）评分进行分层。
在 10037 名合格患者中，有 4334 名患者做出了回应（43.18%）。RR（平均 12.14）的 EF 评分明显低于结肠切除术（平均 15.82）和局部切除术（平均 14.81）（p<0.0001）。结肠切除术和局部切除术之间没有显著差异（p=0.29）。造口和 RT 的使用都是 ED 的独立危险因素。排除造口和 RT 患者并调整年龄和 ASA 评分后，RR 发生 ED 的风险仍然更高（OR 1.42，95%CI 1.20-1.67），与结肠切除术相比。
RR 对 EF 有负面影响。结肠切除术和局部切除术患者之间没有差异。RT 和造口是 ED 的独立危险因素。
