Pidoto R R, Gioffrè Florio M, Cogliandolo A, Micali B
Cattedra di Chirurgia Generale e di Pronto Soccorso, Policlinico Universitario di Messina.
Minerva Chir. 1994 Sep;49(9):767-71.
Seventeen consecutive patients with rectal cancer underwent surgery at our institution between January 1988 and December 1990. The aim of this study was to assess the urogenital symptoms after radical resection of the rectum. Ten of these patients were suitable for the study, 9 of whom had an Anterior Resection (with colorectal anastomosis in 7 cases and with coloanal anastomosis in 2) and 1 a Miles operation. We observed urogenital disturbances in 2 patients (20%), 1 male with urinary tract dysfunction and 1 female with difficulties of sexual activity. The disease-free interval, at 36 months, was 100%. We suggest that curative surgery for rectal cancer can be associated, in overall cases, with a low incidence of urogenital disturbances. This allows the improvement of quality of life without evidence of loco-regional recurrence. A resective approach of rectal cancer, able to preserve nervous fiber of pelvic plexus but providing at the same time a radical excision of the tumor, seems to be a determining factor.
1988年1月至1990年12月期间，我院对17例连续性直肠癌患者进行了手术。本研究的目的是评估直肠癌根治性切除术后的泌尿生殖系统症状。其中10例患者适合本研究，9例行前切除术（7例行结直肠吻合术，2例行结肠肛管吻合术），1例行Miles手术。我们观察到2例患者（20%）出现泌尿生殖系统紊乱，1例男性有泌尿系统功能障碍，1例女性有性活动困难。36个月时的无病间期为100%。我们认为，总体而言，直肠癌根治性手术导致泌尿生殖系统紊乱的发生率较低。这可以在无局部区域复发证据的情况下提高生活质量。一种能够保留盆腔神经丛神经纤维同时又能对肿瘤进行根治性切除的直肠癌切除方法似乎是一个决定性因素。
