Genitourinary Function After Three-port Laparoscopic Rectal Cancer Surgery: A Retrospective Study

Part â… :Feasibility study of three-port laparoscopic rectal cancer surgeryObjective:In recent years, new techniques of laparoscopic rectal cancer surgery have been proposed, which are the supplement and development of conventional technique. These new techniques have their own characteristics, but none has been widely promoted. The safety and feasibility of most of the new technique remains to be demonstrated. Since 2011, we have put forward the three-port laparoscopic rectal cancer surgery. So far we have accumulated a lot of cases. This article aims to compare this technique with conventional laparoscopic technique, to further demonstrate the feasibility of this technique.Method:Reviewed from June 2013 to December 2014, the laparoscopic colorectal cancer surgery cases in our center, for retrospective case-control study. Case screening based on specific inclusion criteria. The patients were classified as "three-port group" and "conventional group" (including the "four-port" and "five-port" laparoscopic colorectal cancer surgery). The comparison is based on the basic characteristics, tumor characteristics, intraoperative situations, short-term prognostic outcomes, and tumor samples.Results:A total of 175 cases of patients matched the criteria and included in the study. After exclusion of patients who received abdominoperineal resection, there are 80 cases in three-port group and 66 cases in the conventional group. Basic preoperative characteristics have no significant difference between two groups of patients in age, gender, BMI, T stage, and N staging. Comparing the position of the tumor, it is higher in three-port group than in the conventional group, the difference is significant (P= 0.000). Intraoperative situations of two groups did not differ significantly. In terms of short-term postoperative prognostic outcomes, in three-port group,5 (6.3%) patients had a fistula, while 6 (9.1%) patients in conventional group; three-port group has another 2 (2.5%) cases of postoperative short-term intestinal obstruction, while conventional group has no such case. In this study, the overall incidence of these two types of complications was 8.9%. In addition, there is no significant difference in open diet time, catheterization time and postoperative hospital stay.Conclusions:For cases with higher located tumor, it can get the surgical outcomes as good as conventional laparoscopic surgery. For cases with lower located tumor or obese patients, the application of three-port technique needs more research.Part â…¡:study of genitourinary function after three-port laparoscopic rectal cancer surgeryObjective:With the improvement of the treatment of rectal cancer, we have made tremendous progress on the survival rate of colorectal cancer. Subsequently, postoperative patients have more requirements of function preservation. There are not enough studies of postoperative urinary and sexual function, especially for laparoscopic new technique. The aim of this paper is to study the genitourinary function after laparoscopic rectal cancer surgery and the risk functions of this common complication. The focus is to study the genitourinary function after three-port laparoscopic surgery.Method:Reviewed from June 2013 to December 2014, the laparoscopic colorectal cancer surgery cases in our center, for retrospective case-control study. Case screening based on specific inclusion criteria. The patients were classified as "three-port group" and "conventional group". Basic information is collected, including basic characteristics, tumor characteristics, type of surgery, pathological data, postoperative complications, follow-up treatment. In addition, the questionnaires of IPSS, IIEF, FSFI are used to assess urinary and sexual function after surgery. Data were statistically analyzed.Results:After screening,111 patients were included in the study, including 49 cases in three-port group and 62 cases in conventional group; 69 male cases and 42 female cases. In light of basic characteristics, the median age (P= 0.014), type of surgery (P= 0.002), tumor distance from the anal margin (P= 0.000), postoperative chemotherapy (P= 0.022) have significant differences between the two groups. The scores of male sexual function did not show significant differences before surgery, one month after surgery and three month after surgery. But at the endpoint of six months after surgery (P= 0.026) and one year after surgery (P= 0.017), sexual function of three-port group seems better than the conventional group. The multivariate analysis only found that BMI (P= 0.022) has significant effect on postoperative sexual function. No significant correlation has been found between sexual function and quantity of port. Lots of female cases have been lost during follow-up of sexual function. In univariate analysis of postoperative urinary function, we found the type of surgery (P= 0.058), tumor location (P= 0.056,0.043), postoperative radiotherapy (P= 0.024) have significant correlation with urinary function, but in the multivariate analysis, none has positive result. No significant correlation has been found between sexual function and quantity of port.Conclusions:The three-port laparoscopic rectal cancer surgery and conventional laparoscopic surgery have no significant difference on postoperative urinary and sexual function. Intraoperative nerve exposure and protection could be as same as in conventional laparoscopic surgery in appropriate cases, implied three-port technique is feasible and safe.