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比较保留或切除 Denonvilliers 筋膜对接受腹腔镜根治性前列腺切除术男性的尿控和性功能的影响。

Comparing the effects of retention or resection of the Denonvilliers' fascia on urinary and sexual functions in men who underwent laparoscopic radical.

机构信息

Affiliated Hospital, Hangzhou Normal University, Hangzhou, China.

Department of General Surgery, The Affiliated Hospital of Hangzhou Normal University, Hangzhou, China.

出版信息

Asian J Surg. 2024 Aug;47(8):3405-3416. doi: 10.1016/j.asjsur.2024.01.126. Epub 2024 Feb 1.

Abstract

Currently, colorectal cancer has the third highest incidence worldwide. As its incidence is increasing, focus on quality of life after laparoscopic radical resection for colorectal cancer has also increased. This study aimed to compare the effects of retention or resection of the Denonvilliers'fascia on urinary and sexual functions in men who underwent laparoscopic radical resection for rectal cancer. Relevant national and international literature databases, including China Knowledge Network, PubMed, Cochrane Library, and Excerpta Medica Database, were searched according to the established retrieval scheme. Review Manager 5.3 was used to analyze data, and the correct effect model was selected based on heterogeneity. In total, 22 studies involving 2255 patients were included in the meta-analysis. The studies were categorized into the experimental and control groups. The incidence of urinary dysfunction was lower in the experimental group than in the control group at 1 and 6 months postoperatively. In terms of sexual function, the experimental group had lower rates of erectile and ejaculatory dysfunctions than the control group at 1, 3, and 6 months and 1 year postoperatively. However, the experimental group had a longer operation time than the control group. No significant differences in incidence of postoperative complications, intra-operative blood loss, and number of lymph nodes dissections were observed between the two groups. Overall, laparoscopic radical resection for rectal cancer with preservation of the Denonvilliers' fascia has been proven effective in improving postoperative urinary and sexual functions in men without affecting the number of lymph nodes dissected and enhancing postoperative quality of life.

摘要

目前,结直肠癌的发病率居全球第三位。随着发病率的上升,人们对腹腔镜直肠癌根治术后生活质量的关注也越来越高。本研究旨在比较保留或切除 Denonvilliers 筋膜对接受腹腔镜直肠癌根治术的男性患者的尿控和性功能的影响。根据既定的检索方案,检索了中国知网、PubMed、Cochrane 图书馆和 Excerpta Medica 数据库等国内外相关文献数据库。采用 Review Manager 5.3 进行数据分析,并根据异质性选择正确的效应模型。共有 22 项研究纳入了 2255 例患者,纳入的研究分为实验组和对照组。术后 1 个月和 6 个月,实验组尿功能障碍的发生率低于对照组。在性功能方面,实验组在术后 1、3、6 个月和 1 年时,勃起和射精功能障碍的发生率低于对照组。然而,实验组的手术时间长于对照组。两组患者术后并发症发生率、术中出血量和淋巴结清扫数量均无显著差异。总的来说,在不影响淋巴结清扫数量和提高术后生活质量的情况下,保留 Denonvilliers 筋膜的腹腔镜直肠癌根治术可有效改善男性患者的术后尿控和性功能。

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