Bladder and male sexual functions after autonomic nerve-sparing TME with or without lateral node dissection for rectal cancer

Abstract

If lateral lymph node dissection should be used with the aim of improving radicality in rectal excision for cancer, it should be combined with careful nerve-preserving technique--which may reduce the risk of bladder and male sexual dysfunctions.

Quality assurance of pelvic autonomic nerve-preserving surgery for advanced lower rectal cancer—preliminary results of a randomized controlled trial

“…Western surgeons believe that neoadjuvant CRT is useful to reduce local recurrence in the pelvic sidewall. However, in Japan, TME with PANP + LLND has been attempted in patients with advanced lower rectal cancer since late 1980s [6][7][8][9][10]. Neoadjuvant CRT has rarely been adopted in most leading hospitals in Japan.…”

“…In the late 1980s, pelvic autonomic nerve-preserving (PANP) operation was introduced in rectal cancer surgery [4,5]. To balance the oncologic and functional outcomes, PANP with LLND surgery has been attempted by leading Japanese colorectal surgeons [3,4,[6][7][8][9][10]. The reported local recurrence rates in Dukes C patients with lower rectal cancer ranged from 7.4% to 19.6% after PANP with LLND, without the use of adjuvant or neoadjuvant radiotherapy [3,6,7,9].…”

Disorders in urinary bladder micturition after rectal operations

“…Originalien Funktionelle Harnblasenentleerungsstörungen nach Rektumoperationen werden häufig beobachtet und dennoch in der Fachliteratur kaum thematisiert [1][2][3][4][5][6][7][8][9]. Für die Miktionsstö-rungen werden unterschiedliche Faktoren verantwortlich gemacht.…”

“…Das Ausmaß einer Blasenfunktionsstörung nach Rektum operation hängt sowohl von der Ausprä gung und Lokalisation der Nervenschä digung als auch von einer Lageverände rung der Harnblase oder dem Auftreten einer perivesikalen Entzündung ab. Funk tionelle Harnblasenentleerungsstörungen nach Rektumoperation wurden in der Li teratur mit 0-41% beschrieben[1,[3][4][5][6][7][8].Mit unserer klinischen Studie an einem unizentrischen Patientenkollektiv wollen wir einen Beitrag zur Klärung von Inzi denz und Form von Blasenentleerungs störungen nach einer Rektumoperation leisten.V. Zugor · I. Miskovic · K. Matzel · W. Hohenberger · W. Neuhuber · A. Labanaris · G.E.…”

Current Surgical Management of Rectal Cancer

“…To address this problem, several reports from Japanese surgeons have demonstrated various pelvic autonomic nerve preservation (ANP) procedures with lateral lymph node dissection which resulted in improved urinary and sexual function compared to previous results [20, 24, 25]. Mori et al [20] combined ANP resection with lateral lymph node dissection in patients with advanced lower rectal cancer.…”