Kolokotronis Theodoros, Pantelis Dimitrios
Department of Surgery and Centre of Minimal Invasive Surgery, GFO Kliniken Bonn, Bonn 53225, North Rhine-Westphalia, Germany.
World J Gastroenterol. 2024 Dec 21;30(47):5081-5085. doi: 10.3748/wjg.v30.i47.5081.
This manuscript focused on the surgical challenge of urinary and sexual dysfunction after rectal cancer surgery based on the interesting results demonstrated by the observational study of Chen , which was published in the . Urinary dysfunction occurs in one-third of patients treated for rectal cancer. Surgical nerve damage is the main cause of urinary dysfunction. Radiotherapy seems to exacerbate sexual dysfunction. The role of Denonvilliers' fascia preservation resection when performing total mesorectal excision (TME), the impact of robotic and transanal TME, alternatives to open and laparoscopic TME, as well as intraoperative pelvic neuromonitoring are discussed in this report. In conclusion, exact knowledge of the highly complex pelvic neuroanatomy and the use of novel surgical techniques can lead to a reduction in urinary and sexual dysfunction after rectal cancer surgery.
基于陈发表在……上的观察性研究得出的有趣结果，本手稿聚焦于直肠癌手术后泌尿和性功能障碍的手术挑战。三分之一接受直肠癌治疗的患者会出现泌尿功能障碍。手术神经损伤是泌尿功能障碍的主要原因。放疗似乎会加重性功能障碍。本报告讨论了在进行全直肠系膜切除术（TME）时保留/切除 Denonvilliers 筋膜的作用、机器人辅助和经肛门 TME 的影响、开放和腹腔镜 TME 的替代方法以及术中盆腔神经监测。总之，对高度复杂的盆腔神经解剖结构的准确了解以及新型手术技术的应用可减少直肠癌手术后的泌尿和性功能障碍。
