Function preservation in rectal cancer surgery

Abstract

When total mesorectal excision (TME) is accurately performed, dysfunction, theoretically, does not occur. However, there are differences among individuals in the running patterns and the volumes of nerve fibers, and if obesity or a narrow pelvis is present, nerve identification is difficult. Currently, the rate of urinary dysfunction after rectal surgery ranges from 33% to 70%. Many factors other than nerve preservation play a role in minor incontinence. Male sexual function shows impotence rates ranging from 20% to 46%, while 20%-60% of potent patients are unable to ejaculate. In women, information on sexual function is not easily obtained, and there are more unknown aspects than in men. As urinary, sexual, and defecation dysfunction due to adjuvant radiotherapy have been reported to occur at a high frequency, the creation of a protocol that enables analysis of long-term functional outcome will be essential for future clinical trials. In the treatment of rectal cancer, surgeon-related factors are extremely important, not only in achieving local control but also in preserving function. This article reviews findings from recent studies investigating urinary, sexual, and defecation dysfunction after rectal cancer surgery and discusses questions to be studied in the future.

Quality of Life and Psychological Well-Being of Colorectal Cancer Survivors in Jordan

“…This is similar to results of previous studies (Schmidt et al, 2005a;Di Fabio et al, 2008;Den Oudsten et al, 2012). Patient education and counseling are essential to improve the outcomes of this domain (Moriya, 2006). Regarding sexual interest in men, its mean score was better and the only statistically significant predictors of it were tumor size and site of cancer.…”

Effects of Radiation Therapy for Rectal Cancer on Anorectal Function

“…New techniques have been designed to minimize these complications [9][10][11], particularly the introduction of the nerve sparing total mesorectal excision technique. The goal of these techniques is to provide negative circumferential margins while minimizing the incidence of complications due to neural injury, such as genitourinary dysfunction.…”

Surgical and pathomorphological results of total mesorectumectomy by using waterjet dissection technique in patients with rectal cancer

“…Поиск возможностей сохранения вегетативных нервных сплетений при проведении операций у паци-ентов с раком прямой кишки является объектом при-стального внимания многих авторов последние не-сколько лет [15][16][17]. В мировой литературе имеется информация (в том числе экспериментальные данные) о меньшей степени латерального термического повре-ждения вегетативных нервов при мобилизации прямой кишки с применением гармонического скальпеля по сравнению с использованием монополярного коагу-лятора [18,19].…”