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Urogenital function following laparoscopic and open rectal cancer resection: a comparative study
Emma Rose McGlone1, Omar Khan, Karen Flashman
1Department of Lower GI Surgery, National Training Centre for Laparoscopic Colorectal Surgery, Queen Alexandra Hospital, Portsmouth, PO6 3LY, UK.
Surgical Endoscopy
|April 6, 2012
Summary
Laparoscopic rectal surgery shows better sexual function outcomes than open surgery, especially for women. Both methods impact urinary function similarly, but laparoscopy preserves sexual health more effectively.
Area of Science:
- Oncology
- Surgical Innovation
- Patient Outcomes
Background:
- Pelvic surgery, including rectal resection, carries risks of sexual and urinary dysfunction.
- Evidence comparing laparoscopic and open rectal surgery for functional outcomes is conflicting.
- High-volume centers are crucial for evaluating surgical technique impacts.
Purpose of the Study:
- To analyze the impact of surgical technique (laparoscopic vs. open) on sexual and urinary function after rectal cancer resection.
- To compare functional outcomes between laparoscopic and open rectal surgery in a high-volume center.
Main Methods:
- Prospective database identification of 173 rectal cancer patients undergoing elective laparoscopic or open surgery (2006-2009).
- Validated postal questionnaires assessed postoperative sexual and urinary function in 144 responders.
- Functional data quantified using validated indices.
Main Results:
- Both surgical approaches led to urinary and sexual function deterioration.
- No significant difference in urinary function deterioration between laparoscopic and open groups for either gender.
- Laparoscopic surgery showed less deterioration in male sexual function (successful penetration, p=0.04).
- Laparoscopic surgery demonstrated significantly better female sexual function outcomes (arousal, lubrication, orgasm, dyspareunia).
Conclusions:
- Laparoscopic total mesorectal excision for rectal cancer is linked to reduced sexual function decline compared to open surgery.
- The benefits of laparoscopic surgery on sexual function are particularly notable in female patients.
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