手助腹腔镜全直肠系膜切除术中盆自主神经保护型男性性功能的影响

目的探讨手助腹腔镜全直肠系膜切除术中盆腔自主神经保护的可行性及对术后性功能的影响。方法2011年1～7月应用手助腹腔镜完成男性直肠癌全直肠系膜切除术19例，以同期开腹手术22例作对照。比较术后性功能障碍的发生率。结果手助腹腔镜组与开腹组术后勃起功能障碍发生率分别为10．53％、13．64％，射精功能障碍发生率分别为21．05％、22．73％；两组比较差异无统计学意义（P〉0．05）。结论手助腹腔镜全直肠系膜切除术中盆腔自主神经保护安全、可行，术中能更清晰地显露盆腔自主神经并予以保护，有效地降低术后性功能障碍的发生率。

Effect of pelvic autonomic nerve preservation on sexual function in male patients with rectal carcinoma undergoing hand-assisted laparoscopic total mesorectal excision

Objective To evaluate the sexual function of male patients with rectal carcinoma following hand-assisted laparoscopic total mesorectal excision with pelvic autonomic nerve preservation.Methods From January to July 2011,19 male patients were allocated to hand-assisted laparoscopic total mesorectal excision and 22 to open TME.The clinical data of patients were retrospectively analyzed.The sexual dysfunction rate of male patients in the two groups were compared.Results The erectile dysfunction and ejaculatory disorder rate were 10.53% and 21.05% in the hand-assisted laparoscopic group,and13.64%、22.72% in the open groug,respectively.No significant difference between the two groups was found(P > 0.05).Conclusion Pelvic autonomic nerve preservation through hand-assisted laparoscopic total mesorectal excision is safety and feasible,and can effectively reduce the incidence of sexual dysfunction after operation.It is more easier for exposure and protection pelvic autonomic nerve in the operation.