目的:探讨在腹腔镜直肠癌根治手术中保留盆腔植物神经(PANP)对男性局部复发率、生存率和术后生活质量的影响.方法:不同时期的2组腹腔镜直肠癌根治手术病人,其中非保留盆腔植物神经组34例,保留组88例,回顾性分析比较2组患者的局部复发率、5年存活率及术后排尿功能和性功能.结果:两组均顺利完成手术.其中保留植物神经组82例获得随访,未保留组28例获得随访.局部复发率保留植物神经组为7.3％(6/82),未保留组7.1％(18/28)；5年存活率保留植物神经组为84.2％(69/82)未保留组为82.1％(23/28),2组差异无统计学意义(P＞0.05).排尿功能障碍植物神经组为28.1％(23/82),未保留组为60.7％(17/28)；勃起功能障碍保留植物神经组为24.4％(20/82),未保留组约为67.9％(19/28),射精功能障碍保留植物神经组24.4％(20/82),未保留组71.4％,(20/28),两组比差异均有统计学意义(P＜0.05).结论:腹腔镜直肠癌根治术中保留植物神经功能,对局部复发率和5年存活率无明显影响,但可明显提高患者的生存质量.%Objective: To explore the relationship to rate of local recurrence, rate of survival and quality of life for colorectal cancer in laparoscopic radical surgery with pelvic autonornic nerve preservation(PANP). Methods: Two groups of men were retrospectively analyzed in different periods of laparoscopic surgery, including the pelvic autonomic nerve preservation group(study group) of 88 cases, and the non-preservation group (control group) of 34 cases on rate of local recurrence,a rate of 5-year survival and urinary function and sexual function. Results: All of the cases were completed successfully. The rate of local recurrence, the PANP group was 7.3％(6/82)and the control group was 7.1 ％(18/28), (P＞0.05). For the rate of 5-year survival, the PANP group was 84.2％ (69/82), and the control group was 82.1 ％ (23/28), (P＞0.05). For the injured urinary function, the group of PANP was 28.1 ％(23/82), and the control group was 60.7％ (17/28), (P＜0.05). For the erectile dysfunction, the group of PANP was24.39％ (20/82), and the control group was 67.9％ (19/28), (P＜0.05). For the ejaculatory disorder, the group of PANP was 24.4％ (20/82), and the control group was 71.4％, (20/28), (P＜0.05). Conclusions The laparoscopic radical surgery with pelvic autonomic nerve preservation in rectal cancer would not increase the local recurrence rate ,nor reduce the 5-year survival rate, but may evidently improve the life quality of man patients.
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