Comparison of Urogenital Functions after Transanal and Laparoscopic Total Mesorectal Excision

IF 0.4 4区 医学 Q4 SURGERY
Jinchun Cong, Hong Zhang, Chunsheng Chen, Kun Xu
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Abstract

Urogenital dysfunction after rectal surgery is associated with neurovascular bundle (NVB) injury. We compared urinary and sexual functions after transanal total mesorectal excision (taTME) and laparoscopic total mesorectal excision (laTME), and analysed the impact of the differences in NVB injuries on the functional outcomes of these treatments. Overall, 187 patients with rectal cancer who underwent taTME (n = 94) or laTME (n = 93) at the Shengjing Hospital of China Medical University between March 2018 and June 2021 were included. Ninety-seven patients (taTME, n = 52; laTME, n = 45) with NVB injuries were classified as bleeding subgroups and the others as non-bleeding subgroups. Urinary function was compared 6 and 12 months postoperatively using the International Prostate Symptom Score (IPSS). Sexual function was compared 12 months postoperatively using the five-item International Index of Erectile Function (IIEF-5). The IPSS of all groups at 6 months postoperatively was higher than that preoperatively. All postoperative scores in the bleeding subgroup of the taTME group were significantly higher than the preoperative scores. The bleeding subgroup of the taTME group had higher IPSS and significantly lower IIEF-5 scores than the non-bleeding subgroup of the taTME group and the bleeding subgroup of the laTME group postoperatively. The IIEF-5 scores of all groups at 12 months postoperatively were lower than those preoperatively. This study confirmed impaired urinary and sexual functions after taTME and laTME, and patients with NVB injuries in the taTME group had worse urinary and sexual dysfunction.

Abstract Image

经肛门和腹腔镜中直肠全切除术后泌尿系统功能的比较
直肠手术后的泌尿生殖功能障碍与神经血管束(NVB)损伤有关。我们比较了经肛门全直肠系膜切除术(taTME)和腹腔镜全直肠系膜切除术(laTME)后的排尿功能和性功能,并分析了神经血管束损伤的差异对这些治疗方法的功能结果的影响。共纳入2018年3月至2021年6月期间在中国医科大学附属盛京医院接受taTME(n = 94)或laTME(n = 93)治疗的187例直肠癌患者。97名NVB损伤患者(taTME,n = 52;laTME,n = 45)被分为出血亚组,其他患者被分为非出血亚组。使用国际前列腺症状评分(IPSS)对术后 6 个月和 12 个月的排尿功能进行比较。术后 12 个月,使用五项国际勃起功能指数(IIEF-5)对性功能进行比较。所有组别术后 6 个月的 IPSS 均高于术前。taTME 组出血亚组的所有术后评分均明显高于术前评分。与 taTME 组的非出血亚组和 laTME 组的出血亚组相比,taTME 组的出血亚组术后 IPSS 更高而 IIEF-5 评分明显更低。所有组别在术后 12 个月的 IIEF-5 评分均低于术前。这项研究证实,taTME 和 laTME 术后泌尿和性功能受损,taTME 组 NVB 损伤患者的泌尿和性功能障碍更严重。
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来源期刊
CiteScore
0.60
自引率
25.00%
发文量
412
审稿时长
6-12 weeks
期刊介绍: The Indian Journal of Surgery is the official publication of the Association of Surgeons of India that considers for publication articles in all fields of surgery. Issues are published bimonthly in the months of February, April, June, August, October and December. The journal publishes Original article, Point of technique, Review article, Case report, Letter to editor, Teachers and surgeons from the past - A short (up to 500 words) bio sketch of a revered teacher or surgeon whom you hold in esteem and Images in surgery, surgical pathology, and surgical radiology. A trusted resource for peer-reviewed coverage of all types of surgery Provides a forum for surgeons in India and abroad to exchange ideas and advance the art of surgery The official publication of the Association of Surgeons of India 92% of authors who answered a survey reported that they would definitely publish or probably publish in the journal again The Indian Journal of Surgery offers peer-reviewed coverage of all types of surgery. The Journal publishes Original articles, Points of technique, Review articles, Case reports, Letters, Images and brief biographies of influential teachers and surgeons. The Journal spans General Surgery, Pediatric Surgery, Neurosurgery, Plastic Surgery, Cardiothoracic Surgery, Vascular Surgery, Rural Surgery, Orthopedic Surgery, Urology, Surgical Oncology, Radiology, Anaesthesia, Trauma Services, Minimal Access Surgery, Endocrine Surgery, GI Surgery, ENT, Colorectal Surgery, surgical practice and research. The Journal provides a forum for surgeons from India and abroad to exchange ideas, to propagate the advancement of science and the art of surgery and to promote friendship among surgeons in India and abroad. This has been a trusted platform for surgons in communicating up-to-date scientific informeation to the community.
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