{"title":"Comparison of Urogenital Functions after Transanal and Laparoscopic Total Mesorectal Excision","authors":"Jinchun Cong, Hong Zhang, Chunsheng Chen, Kun Xu","doi":"10.1007/s12262-024-04151-5","DOIUrl":null,"url":null,"abstract":"<p>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 (<i>n</i> = 94) or laTME (<i>n</i> = 93) at the Shengjing Hospital of China Medical University between March 2018 and June 2021 were included. Ninety-seven patients (taTME, <i>n</i> = 52; laTME, <i>n</i> = 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.</p>","PeriodicalId":13391,"journal":{"name":"Indian Journal of Surgery","volume":"9 1","pages":""},"PeriodicalIF":0.4000,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Indian Journal of Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12262-024-04151-5","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
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.
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.