ABSTRACT
The clinical effect of laparoscopic rectal cancer curative excision with pelvic autonomic nerve preservation (PANP) was investigated. This study evaluated the frequency of urinary and sexual dysfunction of 149 male patients with middle and low rectal cancer who underwent laparoscopic or open total mesorectal excision with pelvic autonomic nerve preservation (PANP) from March 2011 to March 2013. Eighty-four patients were subjected to laparoscopic surgery, and 65 to open surgery respectively. The patients were followed up for 12 months, interviewed, and administered a standardized questionnaire about postoperative functional outcomes and quality of life. In the laparoscopic group, 13 patients (18.37%) presented transitory postoperative urinary dysfunction, and were medically treated. So did 12 patients (21.82%) in open group. Sexual desire was maintained by 52.86%, un-ability to engage in intercourse by 47.15%, and un-ability to achieve orgasm and ejaculation by 34.29% of the patients in the laparoscopic group. Sexual desire was maintained by 56.36%, un-ability to engage in intercourse by 43.63%, and un-ability to achieve orgasm and ejaculation by 33.73% of the patients in the open group. No significant differences in urinary and sexual dysfunction between the laparoscopic and open rectal resection groups were observed (P>0.05). It was concluded that laparoscopic rectal cancer radical excision with PANP did not aggravate or improve sexual and urinary dysfunction.
Subject(s)
Adult , Humans , Male , Middle Aged , Autonomic Nervous System , Wounds and Injuries , Laparoscopy , Peripheral Nerve Injuries , Postoperative Complications , Rectal Neoplasms , General Surgery , Sexual Dysfunction, Physiological , Urologic DiseasesABSTRACT
The clinical effect of laparoscopic rectal cancer curative excision with pelvic autonomic nerve preservation (PANP) was investigated. This study evaluated the frequency of urinary and sexual dysfunction of 149 male patients with middle and low rectal cancer who underwent laparoscopic or open total mesorectal excision with pelvic autonomic nerve preservation (PANP) from March 2011 to March 2013. Eighty-four patients were subjected to laparoscopic surgery, and 65 to open surgery respectively. The patients were followed up for 12 months, interviewed, and administered a standardized questionnaire about postoperative functional outcomes and quality of life. In the laparoscopic group, 13 patients (18.37%) presented transitory postoperative urinary dysfunction, and were medically treated. So did 12 patients (21.82%) in open group. Sexual desire was maintained by 52.86%, un-ability to engage in intercourse by 47.15%, and un-ability to achieve orgasm and ejaculation by 34.29% of the patients in the laparoscopic group. Sexual desire was maintained by 56.36%, un-ability to engage in intercourse by 43.63%, and un-ability to achieve orgasm and ejaculation by 33.73% of the patients in the open group. No significant differences in urinary and sexual dysfunction between the laparoscopic and open rectal resection groups were observed (P>0.05). It was concluded that laparoscopic rectal cancer radical excision with PANP did not aggravate or improve sexual and urinary dysfunction.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy of laparoscopic transanal coloanal anastomosis (modified Parks procedure) in sphincter-preserving surgery for low rectal carcinoma.</p><p><b>METHODS</b>Clinical data of 65 low rectal cancer patients undergoing laparoscopic modified Parks procedure from March 2009 to April 2012 in our department were reviewed retrospectively. Fecal continence, urination and sexual function were evaluated.</p><p><b>RESULTS</b>All the patients were followed up from 6 to 38 months after operation. Anastomotic leakage was found in 2 cases, anastomotic stricture in 3 cases, hepatic metastasis in 1 case. No local recurrence occurred. The ratio of satisfactory defecation function was 61.5% (40/65) in six months, 84.2% (48/57) in 1 year and 88.9% (40/45) in 2 years respectively. Urinary dysfunction was found in 7 patients (10.8%). Among 36 male patients, 7 (19.4%) presented erectile dysfunction and 10 (27.8%) ejaculation dysfunction. Among 29 female patients, sexual life of 19 (65.5%) was satisfactory.</p><p><b>CONCLUSION</b>Laparoscopic modified Parks procedure in sphincter-preserving surgery for low rectal cancer can increase the ratio of sphincter-preserving, and improve the functional outcomes of defecation, sex and urination.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Anal Canal , General Surgery , Anastomosis, Surgical , Methods , Colon , General Surgery , Follow-Up Studies , Laparoscopy , Methods , Rectal Neoplasms , General Surgery , Retrospective StudiesABSTRACT
<p><b>OBJECTIVE</b>To establish the genetic background of exon2, exon13, exon11 and exon15 polymorphisms of RET proto-oncogene and study the possible involvement of RET proto-oncogene in the etiology of Hirschsprung disease (HD) in Chinese Han population surrounding Province HuBei.</p><p><b>METHODS</b>The genotype and allele frequencies of RET proto-oncogene polymorphisms were identified by polymerase chain reaction-restriction fragment length polymorphisms (PCR-RFLPS) in 94 HD patients and 122 control subjects.</p><p><b>RESULTS</b>The genotype and allele frequencies of exon2 were AA 0.17, AG 0.72, GG 0.11, A 0.53, G 0.47 in control, and AA 0.61, AG 0.35, GG 0.04, A 0.78, G 0.22 in HD, and those of exon13 were GG 0.30, GT 0.52, TT 0.18, G 0.56, T 0.44 in control, and GG 0.49, GT 0.36, TT 0.15, G 0.67, T 0.33 in HD. There were significant differences in the two polymorphisms above between HD and control. The genotype and allele frequencies of exon11 were AA 0.05, AG 0.16, GG 0.79, A 0.13, G 0.87 in control and AA 0.02, AG 0.14, GG 0.84, A 0.09, G 0.91 in HD, the differences were not found between these two groups about this site. Exon15 were all of CC genotype in spite of control or HD.</p><p><b>CONCLUSIONS</b>These data provide evidences for the contributions of exon2 and exon13 polymorphisms of RET proto-oncogene to susceptibility to HD in Chinese Han population surrounding province.</p>