The Change Of Urine Flowmetry After The Radical Excision For Rectal Cancer And The Affect From Two Operation

Objective:The surgical operation is the main treatment for the therapy of rectal cancer at the present. Operation way include Miles operation and Dixon operation. Traditional radical excision for rectal cancer (TRER) is liable to injure the pelvic autonomic nerves, so that the urinary functional disorder rate after operation is very high. The present, we adopt the pelvic autonomic nerves preservation(PANP) based on total mesorectal excision(TME) principal for reducing the urinary functional disorder rate after operation, but the patients may unavoidably get urinary functional disorder rate at different degree after operation. The purpose of the research is to explore the change of urine flowmetry after two weeks and three months by adopting total mesorectal excision and pelvic autonomic nerves preservation, and to compare the urinary functional disorder rate after operation between Miles operation and Dixon operation, and to provide objective basis for clinical treatment.Methods:From March 2009 to October 2010, A hundred and twenty patients (60 cases were performed Miles operation,60 cases were performed Dixon operation) with rectal cancer were performed with PANP and TME at the Department of Anus and Intestine Surgery of Xin Hua hospital of Da Lian University. All examples were under seventy years, were before Dukes C, were not accepted radiotherapy and chemotherapy and had not urinary functional disorder before operation. The two groups of examples were not difference in age and Dukes stages. All cases were gathered consequence of urodynamics preoperation, two weeks and three months after operation respectively. Maximum flow rate, residual urine volume, voided volume, detrusor contraction pressure and maximal urethral pressure were observed. All cases were asked to complete the International Prostate Symptom Score(IPSS).The results were analyzed by "t" test or chi-square test respectively.Results:â‘ After surgery two weeks between Miles operation and Dixon operation, maximum flow rate were 17.8ml/s and 18.2ml/s, residual urine volume were 2.4ml and 3.3ml, voided volume were 210.3ml and 202.5ml, detrusor contraction pressure were 42.6cmH20 and 42.1cmH20, maximal urethral pressure were 138.3cmH20 and 139.7cmH20. After surgery three months between Miles operation and Dixon operation, maximum flow rate were 18.8ml/s and 19.8ml/s, residual urine volume were 2.3ml and 2.5ml, voided volume were 211.7ml and 213.5ml, detrusor contraction pressure were 50.9cmH20 and 52.9cmH20, maximal urethral pressure were 140.7cmH20 and 142.6cmH20. Two operation were no significant differences.â‘¡Two operation were no significant differences in urine flowmetry at preoperation and postoperation.â‘¢The urinary functional disorder rate of Miles operation and Dixon operation were21.6% 6.67and% respectively in two weeks, two operation was significant differences. The urinary functional disorder rate of Miles operation and Dixon operation were3.33% 1.67and% respectively in three months, two operation was no significant differences. (4)The urinary functional disorder of two operation was urination dysfunction short-term, the urine flowmetry showed reduction of maximum flow rate, increase of residual urine volume, reduction of voided volume, reduction of detrusor contraction pressure, normal of maximal urethral pressure and bladder sense.Conclusions:â‘ The show of urine flowmetry after adopting total mesorectal excision and pelvic autonomic nerves preservation was not change obviously comparing to preoperation. The urinary functional disorder of postoperation appeared possibly short-term and had not appearance obviously future date.â‘¡From future date, the treatment result of Miles operation and Dixon operation to rectal cancer was no significant differences in urine flowmetry and was not urinary functional disorder obviously.