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目的探讨在保留盆腔自主神经下的全直肠系膜切除术(TME)对男性患者术后排尿功能和性功能的影响。方法回顾分析85例直肠癌根治术中保留自主神经组和不保留自主神经组术后排尿和性功能障碍的发生率。结果45例保留自主神经组排尿障碍发生率为24.44%,勃起障碍发生率为33.33%,射精障碍发生率为35.56%;40例不保留组排尿障碍发生率为62.50%,勃起障碍发生率为65.00%,射精障碍发生率为67.50%;两组比较差异有统计学意义(P<0.01)。Miles术排尿障碍发生率为27.78%,勃起障碍发生率为38.89%,射精障碍发生率为33.33%;Dixon术排尿障碍发生率为22.22%,勃起障碍发生率为29.63%,射精障碍发生率为37.04%,两种手术方式之间差异无统计学意义(P>0.05)。结论男性直肠癌患者术中保留自主神经能降低术后排尿功能及性功能障碍的发生率。
Objective To investigate the effect of total mesorectal excision (TME) on the urinary function and sexual function in male patients after preserving pelvic autonomic nerve. Methods The incidence of urination and sexual dysfunction after radical resection of radical resection of 85 patients with rectal autonomic nerve repair and non-retention of autonomic nerve group were retrospectively analyzed. Results The incidence of dysuria in autonomic nerve group was 24.44%. The incidence of erectile dysfunction was 33.33%. The incidence of ejaculation disorder was 35.56%. The incidence of dysuria in 40 cases was 62.50%, and the incidence of erectile dysfunction was 65.00 %, The incidence of ejaculation disorder was 67.50%; the difference between the two groups was statistically significant (P <0.01). The incidence of dysuria in Miles was 27.78%, the incidence of erectile dysfunction was 38.89%, the incidence of ejaculation disorder was 33.33%. The incidence of dysuria in Dixon was 22.22%, the incidence of erectile dysfunction was 29.63%, and the incidence of ejaculation disorder was 37.04 %, There was no significant difference between the two surgical methods (P> 0.05). Conclusion Intraoperative preservation of autonomic nerve in male patients with rectal cancer can reduce the incidence of postoperative urination and sexual dysfunction.