The Efficacy of a Nerve Stimulator (Cavermap®) to Enhance Autonomic Nerve Identification and Confirm Nerve Preservation During Total Mesorectal Excision

Silva, Giovanna M. da; Zmora, Oded; Börjesson, Lars; Mizhari, Nelly; Daniel, Norma; Khandwala, Farah; Efron, Jonathan E.; Weiss, Eric G.; Nogueras, Juan J.; Vernava, Anthony M.; Wexner, Steven D.

doi:10.1007/s10350-004-0718-5

Cited by 37 publications

(22 citation statements)

References 10 publications

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“…17,34,45 Preliminary studies suggest that use of a nerve-stimulating device may further help in identification and preservation of pelvic autonomic nerves to avoid bladder and sexual dysfunction during total mesorectal excision. 45,46 CONCLUSIONS It is believed that definitive colostomy has a major negative impact on quality of life. However, this study suggests that unpredictable bowel function may be the factor that most disturbs the quality of life.…”

Section: Discussionmentioning

confidence: 98%

Impact of Functional Results on Quality of Life After Rectal Cancer Surgery

Vironen

Kairaluoma

Aalto³

et al. 2006

Diseases of the Colon &Amp; Rectum

205

147

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Quality of life after rectal cancer surgery is not worse than that of the general population. The major adverse impact of bowel and urogenital dysfunction is on social functioning. These adverse effects need to be discussed with the patient and preoperative function needs to be taken into account when choosing between treatment options. Permanent colostomy is not always the factor that disrupts a person's quality of life most.

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Section: Discussionmentioning

confidence: 98%

Impact of Functional Results on Quality of Life After Rectal Cancer Surgery

Vironen

Kairaluoma

Aalto³

et al. 2006

Diseases of the Colon &Amp; Rectum

205

147

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“…Along with meticulous surgical technique, intraoperative nerve stimulation techniques have been developed in the last few years in order to identify nerves nd confirm nerve preservation during TME [48][49][50]. Hanna et al studied penile turgescence after nerve stimulation.…”

Section: Quality Of Dissectionmentioning

confidence: 99%

Sexual and urinary dysfunction after proctectomy for rectal cancer

Eveno

Lamblin

Mariette

et al. 2010

Journal of Visceral Surgery

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Sexual and urinary dysfunction occur frequently after rectal surgery. Total mesorectal excision (TME) is currently the optimal technique for resection of rectal cancer, providing superior carcinological and functional outcomes. Age, pre-operative radiation therapy, abdominoperineal resection, and surgery which fails to respect the "sacred planes" of TME are the four major risk factors for post-operative sexual and urinary sequelae. In the era of TME, postoperative sexual dysfunction ranges from 10-35%, depending on the scores used to assess it, while urinary sequelae have decreased to less than 5%. The place of laparoscopic surgery remains to be defined, particularly with respect to these complications. It is essential to inform the patient pre-operatively about the possibility of such disorders not only for patient informed consent but also to help with correct post-operative management of the problem. Management is multifaceted, and includes psychological, pharmacological, and sometimes surgical therapy.

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“…To avoid excessive bleeding and accidental nerve disruption during surgery, it is important to adhere to the surgical plane and reduce the use of blunt dissection. Also, the use of a nerve-stimulating device may facilitate preservation of the pelvic autonomic nerves during pelvic dissection [14]. …”

Section: Description Of Casementioning

confidence: 99%