Effect Of Denonvilliers’ Fascia Preservation Versus Resection During Laparoscopic Resection For Rectal Cancer On Postoperative Urogenital Function Of Male Patients:a Meta Analysis

AIM: To evaluate the effect of Denonvilliers’ fascia preservation and resection on urinary and sexual function in male patients undergoing laparoscopic radical resection of rectal cancer by meta-analysis.Methods: According to the formulated retrieval strategy,the related literature databases at home and abroad(China National Knowledge Infrastructure(CNKI),Chinese Sci-tech Journals Database,Wanfang Database,Pub Med,Cochrane Library,EMBASE,etc.)were searched.The time limit is from the database establishment to November 30,2022,and the languages are limited to Chinese and English.Clinical studies that meet the research requirements were included,the quality of related literatures was evaluated,extract the data needed for research from high-quality literature,and make statistics and records.The extracted outcome indicators were systematically evaluated and meta-analyzed,and the data were statistically analyzed by Review Manager 5.3 and Stata MP 16.Results: According to the retrieval strategy and screening criteria,21 articles were finally included in this Meta-analysis,including 9 randomized controlled trials and 12 non-randomized controlled trials.A total of 2229 patients were included,including 1149 patients in the retention group and 1080 patients in the non-retention group.Meta-analysis showed that urinary function: The incidence of urinary dysfunction in the retention group was lower at 1 month and 6 months after operation.IPSS was lower in the retention group at 1 month and 3 months after operation.The difference was statistically significant(P<0.05);Sexual function: The incidence of erectile dysfunction and ejaculation dysfunction in the retention group was lower at 1month,3 months,6 months and 1 year after operation.The IIEF-5 score in the retention group was higher at 3 months,6 months and 1 year after operation.The difference was statistically significant(P<0.05);However,the operation time consumed by the retention group was longer,and the difference was statistically significant(P<0.05);There was no significant difference in IPSS 6 months after operation,operation time,intraoperative blood loss and the number of lymph nodes obtained(P>0.05).Conclusion: Laparoscopic radical resection of rectal cancer with Denonvilliers fascia preserved can effectively improve postoperative urinary and sexual function and improve postoperative quality of life in male patients without affecting lymph node dissection.