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World Journal of Surgery
Published in: World Journal of Surgery 6/2006

01-06-2006

Impact of Autonomic Nerve Preservation and Lateral Node Dissection on Male Urogenital Function after Total Mesorectal Excision for Lower Rectal Cancer

Authors: Kennoki Kyo, MD, PhD, Shinichi Sameshima, MD, PhD, Minoru Takahashi, MD, PhD, Taiki Furugori, MD, Toshio Sawada, MD, PhD

Published in: World Journal of Surgery | Issue 6/2006

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Abstract

Introduction

Urogenital dysfunction is a well recognized complication of rectal cancer surgery. The aim of this study was to assess the impact of autonomic nerve preservation (ANP) and lateral node dissection (LND) on male urogenital function after total mesorectal excision for lower rectal cancer.

Methods

We studied, using a questionnaire, preoperative and current urogenital function in 47 male patients who underwent total mesorectal excision with the ANP technique for lower rectal cancer. Patients with and without LND were analyzed separately.

Results

A total of 37 patients (78.7%) (22 patients without LND, 15 with LND) returned the questionnaire. Among the 15 patients with LND, 2 underwent unilateral ANP. One patient without LND had urinary dysfunction preoperatively, and among the other 21 patients only 2 (9.5%) reported minor urinary complications postoperatively. After LND, 5 patients (33%) reported minor complications; there were no severe complications. Among patients who were sexually active prior to the operation, 90% and 70% of patients without LND and 50% and 10% of those with LND maintained sexual activity and ejaculation, respectively. However, 50% of patients who underwent low anterior resection or Hartmann resection without LND and all patients with abdominoperineal resection or LND reported reduced overall sexual satisfaction.

Conclusions

The ANP technique offers the great advantage of maintaining urogenital function after rectal cancer surgery. After LND, although the ANP technique minimized urinary dysfunction, sexual function, particularly ejaculation, was often damaged. Careful follow-up is important even after ANP to improve postoperative sexual satisfaction.
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Metadata
Title
Impact of Autonomic Nerve Preservation and Lateral Node Dissection on Male Urogenital Function after Total Mesorectal Excision for Lower Rectal Cancer
Authors
Kennoki Kyo, MD, PhD
Shinichi Sameshima, MD, PhD
Minoru Takahashi, MD, PhD
Taiki Furugori, MD
Toshio Sawada, MD, PhD
Publication date
01-06-2006
Publisher
Springer-Verlag
Published in
World Journal of Surgery / Issue 6/2006
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-005-0050-9

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