经腹腔镜与开腹行男性中低位直肠癌根治术对性功能影响的比较

摘要

目的:探讨经腹腔镜与开腹行男性中低位直肠癌根治术对患者性功能的影响.方法:103例年龄＜65岁的男性中低位直肠癌患者,其中62例经腹腔镜行根治术(L组)；41例行常规开腹根治术(O组).术后6个月及12个月根据勃起功能障碍国际指数问卷调查表(international index erectile function,IIEF-5)和射精功能的恢复情况评价2组患者的勃起功能.结果:2组患者术后6个月的IIEF-5评分均较术前有所降低,但L组的下降幅度无统计学意义(P＞0.05),O组的下降幅度有统计学意义(P＜0.05)；术后6个月L组的IIEF-5评分较O组高,且差异有统计学意义(P＜0.05)；术后12个月L组的IIEF-5评分仍高于O组,但差异无统计学意义(P＞0.05).术后6个月L组与O组的分别为27.4％(17/62)和41.2％ (17/41);术后12个月I组与O组射精功能障碍发生率分别为25.8％(16/62)和36.6％ (15/41);2组在术后6个月及术后12个月的射精功能障碍发生率的差异均有统计学意义(P＜0.05).结论:男性中低位直肠癌经腹腔镜行根治术对性功能的影响小于开腹根治术.%Objective:To compare the sexual dysfunction after laparoscopic and open radical resection in patients with mid-low rectal cancer. Methods:A total of 103 male patients (age<65years) with mid-low rectal cancer were randomly divided into 2 groups: laparoscopic radical resection group (Group L,n = 62) and traditional open surgery group (Group O,n = 41). Sexual dysfunction and ejaculation dysfunction were analyzed retrospectively at different time point after operation by questionnaire of international index erectile function (IIEF-5). Results: The IIEF-5 scores before operation were (9. 71 ± 0. 23) in Group L and (9. 59 ± 0. 28) in Group O. At 6 months after operation the IIEF-5 scores were (9. 17 ± 0. 36) in Group L and (5. 67 ± 0. 59) in Group O. At 12 months after operation they were (9. 33 ± 0. 61) and (8. 84 ± 0. 47),respectively. IIEF-5 scores in both groups were lower after operation than before operation,and the difference was significant in Group O (P<0. 05),but not significant in Group L(P>0. 05). At 6 months after operation,the incidence of ejaculatio dysfunction was 27. 4% in Group L and 41. 2% in Group O,while at 12 months after operation they were 25. 8% and 36. 6%,respectively. Conclusions: Laparoscopic radical resection for male patients with mid-low rectal cancer is better for sexual function recovery than traditional open surgery.