Recent Advance of Autonomic Nerve Preserving Operation for Rectal Cancer

Shigeo Ohki, Hideyuki Ike, Akira Sugita, Shigeki Yamaguchi, Yasushi Ichikawa, and Hiroshi Shimada

Department of Surgery, Yokohama City University

In the recent treatment of rectal cancer, both radicality and postoperative funtion are required according to the cancer stage. We are performing two types of autonomic nerve preserving operation. One is total autonomic nerve preserving operation (TANPO) in order to maintain both male sexual function and urinary function, and the other is partial pelvic piexus perserving operation (PPPPO) in oder to maintain urinary function at the least. TANPO means that automonic nerves such as lumbar sympathetic nerves, pelvic splanchnic nerves and pelvic plexus are completely preserved. PPPPO means that a part of pelvic splanchnic nerves from sacral foramen S2, S3 or S4 and a part of pelvic plexus are preserved. TANPO is suitable for the rectal cancer whose finding is up to A1N0 (upper rectum) or MPN0 (lower rectum). PPPPO is suitable for the rectal cancer whose finding is SE or N (+) (upper rectum), or A1N0 (lower rectum). Five year survival rates of total preservation, Preservation of S234 and preservation of S34, S4 are 87. 0% (n=33), 93. 6% (n=15), and 92. 3% (n=56), respectively.

Key words
rectal cancer, autonomic nerve preserving operation, postoperative ejaculation

Reprint requests
Shigeo Ohki Department of Surgery, Yokohama City University Urafune Hospital. 3-46 Urafune-cho, Minami-ku, Yokohama, 232-0024, JAPAN

Accepted
October 26, 1999

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