在高结合性西格莫切除术后对排便,尿道和性功能的影响:对一个多中心随机对照试验的后期分析,比较扩展与标准完整的中大肠切除术
Pere Planellas1,2,3, Franco Marinello4, Garazi Elorza5
1Colorectal Surgery Unit, Department of General and Digestive Surgery, University Hospital of Girona, 17007, Girona, Spain. planellasp@gmail.com.
Langenbeck's archives of surgery
|August 1, 2023
概括
在结肠癌的西格莫切除术期间,较高的下半导体动脉结合导致显著的排便和生殖泌尿功能障碍. 年龄是手术后性功能障碍恢复的关键因素.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术瘤学手术瘤学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 胃肠病学 胃肠病学
背景情况:
- 结肠癌的西格莫切除术带有神经损伤的风险,可能导致排便,泌尿和性功能障碍.
- 这些功能性缺陷往往被低估,并在西格结肠切除后被低估.
研究的目的:
- 为了评估高下等关动脉 (IMA) 绑定在西格莫切除术期间对术后排便,泌尿和性功能的影响.
- 为了确定影响Sigmoid结肠癌手术后功能恢复的因素.
主要方法:
- 一个多中心,单盲,随机临床试验的二次分析,比较扩展完整的中切除术 (e-CME) 和标准的CME (s-CME).
- 患有西格腺癌的患者完成了验证的问卷,评估了手术前和手术后1个月和1年的功能结果.
- 采用多变量分析来确定手术因素与功能结果之间的关联.
主要成果:
- 一年后的sigmoidectomy与高IMA绑定,27.9%的经历低前置切除综合征 (LARS),22.2%的男性和29.4%的女性有尿功能障碍,43.8%的男性和27.3%的女性报告性功能障碍.
- 年龄是两性性功能障碍的唯一显著预测因素.
- 糖尿病与女性的胃肠道和尿道恢复较差相关,而治疗臂与勃起功能恢复有关.
结论:
- 在sigmoidectomy期间高IMA结合与大量排便和生殖尿功能障碍的发生率有关.
- 年龄是影响性功能障碍恢复的重要因素,在西格结肠切除1年后.
- 虽然e-CME显示男性尿路功能障碍的高率,但多变量分析没有证实这一关联.
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