Urinary Function After Laparoscopic Radical Resection For Rectal Cancer With Unilateral Pelvic Autonomic Nerve Preservation

Objective:To evaluate the urinary function after laparoscopic radical resection with unilateral pelvic autonomic nerve protection for rectal cancer,this thesis aims to provide evidence for preoperative consultation and postoperative quality of life assessment for patients with high nerve injury potential.Methods:1.Screening cases:Collecting and selecting the patients who underwent laparoscopic assisted radical resection for rectal cancer in gastrointestinal surgery in our hospital according to the principles of TME and PANP?total mesorectal excision and pelvic autonomic nerve preservation?from February 2014 to June 2017.A total of 128 patients were enrolled.Enrolled criteria were as follows:?1?Patients who underwent laparoscopic assisted radical resection for rectal cancer in gastrointestinal surgery in our hospital according to the principles of pelvic autonomic nerve preservation from February 2014 to June 2017 were chosen.?2?The results of enteroscopy and pathology were rectal cancer or malignant neoplasm of rectum.?3?The function of urination was normal before operation.?4?The distance from lower edge of the tumor to the anal was?12cm.2.Grouping methods and observation indicators:Patients were divided into study group?unilateral pelvic autonomic nerve protection group?and control group?bilateral pelvic autonomic nerve protection group?according to the degree of tumor infiltration and operation methods.This thesis compared the urination functions of 2 weeks and 3 months after operation between the two groups and collected residual urine volume,maximal flow rate,voided volume and incidence of urination dysfunction.Results:1.There were 33 patients?45.83%?of urination dysfunction in the study group and 14 patients?25.00%?in the control group after 2 weeks of operation.The result in the study group was higher??2=4.470,P=0.015?.The levels of RUV in the study group and the control group were?25.90±7.83?mL,?23.05±7.91?mL.The level of RUV in the study group was higher?t=2.209,P=0.029?.The levels of Q_max in the study group and the control group were?17.78±1.24?mL/s,?18.45±1.56?mL/s.The level of Q_max in the study group was lower?t=-2.708,P=0.008?.The level of V_compomp was?199.63±18.42?mL in the study group and?206.30±13.36?mL in the control group.The level of V_comp in the study group was lower?t=-2.282,P=0.024?.2.There were 14 patients?19.40%?of urination dysfunction in the study group and 5 patients?8.90%?in the control group after 3 months of operation.There was no significant difference between the two groups??2=2.756,P=0.097?.The levels of RUV in the study group and the control group were?20.60±9.74?mL,?19.60±8.55?mL.There was no significant difference between the two groups?t=-0.607,P=0.545?.The levels of Q_maxax in the study group and the control group were?18.42±1.17?mL/s,?19.34±1.32?mL/s.The level of Q_max in the study group was lower?t=4.081,P<0.001?.The level of V_comp was?207.25±19.80?mL in the study group and?212.60±15.46?mL in the control group.There was no significant difference between the two groups?t=1.681,P=0.095?.Conclusion:Compared with the protection of bilateral pelvic autonomic nerve,the urination function of the protection of the unilateral pelvic autonomic nerve are lower than the protection of the bilateral pelvic autonomic nerve in a short time.With the postoperative time pass by,however,the urination function can achieve the same effect in both groups.