| 唐毓林,张涌泉,许景洪.低位直肠癌全直肠系膜切除手术中保留盆腔自主神经侧方淋巴结清扫的临床价值[J].肿瘤学杂志,2016,22(5):369-373. |
| 低位直肠癌全直肠系膜切除手术中保留盆腔自主神经侧方淋巴结清扫的临床价值 |
| Clinical Value of Lateral Lymph Node Dissection with Pelvic Autonomic Nerve Preservation in Total Mesorectal Excision Surgery for Low Rectal Cancer |
| 投稿时间：2014-10-16 |
| DOI：10.11735/j.issn.1671-170X.2016.05.B007 |
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| 中文关键词: 直肠癌肿瘤 全直肠系膜切除 保留盆腔自主神经 侧方淋巴结清扫 |
| 英文关键词:rectal neoplasms total mesorectal excision(TME) pelvic autonomic nerve preservation lateral lymph node dissection |
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| 中文摘要: |
| 摘 要：［目的］ 探讨低位直肠癌全直肠系膜切除（TME）手术中保留盆腔自主神经并行侧方淋巴结清扫的临床效果。［方法］ 对接受TME手术治疗的81例低位直肠癌患者的临床资料进行回顾性分析，根据术中是否保留盆腔自主神经并行侧方淋巴结清扫术分组。对照组患者接受单纯TME手术治疗，研究组患者TME手术中保留盆腔自主神经并行侧方淋巴结清扫。术后随访1~5年，对比两组患者在排尿障碍、男性性功能障碍、术后盆腔局部复发率、术后5年生存率等方面的差异。［结果］ 研究组侧方淋巴结转移阳性率2.56%，对照组为0；研究组术后盆腔局部复发率5.12%，5年生存率为87.36%；对照组则分别为11.90%和64.35%。上述3项指标两组之间比较差异均有统计学意义(P<0.05)。对照组和研究组患者排尿功能障碍发生率分别为28.57%和12.82%；术后男性性功能障碍发生率分别为92.86%和34.62%，两组比较差异均具统计学意义(P<0.05)。［结论］ 低位直肠癌TME手术中保留盆腔自主神经侧方淋巴结清扫可有效改善患者排尿障碍、男性性功能障碍，降低术后盆腔局部复发的发生，提高术后5年生存率。 |
| 英文摘要: |
| Abstract：［Objective］To investigate the clinical effect of lateral lymph node dissection with pelvic autonomic nerve preservation in total mesorectal excision(TME) surgery for low rectal cancer. ［Methods］ A total of 81 cases with low colorectal cancer undergoing TME surgery were analyzed retrospectively. Patients were divided into 2 groups according to whether undergoing lateral lymph node dissection or not. Control group patients received TME surgery alone and study group received lateral lymph node dissection with pelvic autonomic nerve preservation in TME surgery. Patients were followed up for one to five years，and the differences in urination disorder，male sexual dysfunction，postoperative pelvic recurrence rate，5-year survival in the two groups were compared. ［Results］ The positive rate of lateral lymph node metastasis of study group was 2.56% while that of control group was 0. In study group，postoperative pelvic recurrence rate was 5.12% and 5-year survival was 87.36%；and those were 11.90% and 64.35% retrospectively in control group. The above three indicators between the two groups were statistically significant(P<0.05). In control group and study group，urination disorder rate was 28.57% and 12.82%，and postoperative sexual dysfunction rate was 92.86% and 34.62%，retrospectively，both with significant difference between the two groups(P<0.05). ［Conclusion］ Lateral lymph node dissection with pelvic autonomic nerve preservation in TME surgery for low rectal cancer might effectively ameliorate urination disorder and male sexual dysfunction，reduce postoperative pelvic recurrence and improve 5-year survival. |
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