The Evaluation of the Long Term Survival and Functions in the Autonomic Nerve-sparing Operation with Pre-operative Radiotherapy for Rectal Cancer

Norio Saito, Hiromi Sarashina, Masao Nunomura, Keiji Koda, Nobuhiro Takiguchi, Hiroaki Soda, Kazuyoshi Ozaki, Yoshiki Sugaya, Nobuyuki Nakajima

First Department of Surgery, School of Medicine, Chiba University

one handred and ninety five patients have been received autonomic nerve-sparing operations for rectal cancer in our department since 1984. These patients were classified into two groups, those with preoperative irradiation (irradiated group) and those with surgery alone. The survival rates and the local recurrence rates for these patients were compared, and post-operative urinary and male sexual functions were discussed. The overall cumulative five-year and nine-year survival rates were 80.3% and 66.5%, whereas those in the irradiated group were 84.0% and 77.7%, and those in the surgery alone group were 74.6% and 62.9%. Local recurrence rates were 9.6% all, 5.6% in the irradiated groups, and 11.9% in the surgery alone group. Maintenance of urinary function was successful in almost all patients with bilateral and unilateral pelvic nerve plexus. But the sexual function in males especially ejaculation was preserved in only 54.5% of the patients with bilateral hypogastric nerve and pelvic plexus, and in only 14.3% of the patients with unilateral seving. There was no significant defference in the outcome of the two group, but there was a tendency to obtain the better survival and to decrease the local recurrence in the irradiated group. It was difficult to preserve the sexual function by the nerve-sparing operation with lymphadevectomy.

Key words
rectal cancer, autonomic nerve-sparing surgery, preoperative radiotherapy, urinary function, sexual function (male)

Reprint requests
Norio Saito First Department of Surgery, Chiba University School of Medicine
1-8-1 Inohana, Chuo-ku, Chiba, 260 JAPAN

Accepted
January 8, 1997

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