Original CommunicationsA prospective study of sexual and urinary function before and after total mesorectal excision with autonomic nerve preservation for rectal cancer*
Section snippets
Patients and methods
Between March 1996 and April 1997, all consecutive patients who underwent operations for rectal carcinoma in our department were evaluated for inclusion in the study. All those undergoing TME with sphincter preservation were eligible. Patients who had preoperative radiotherapy, prior rectal operations, APR, or no preoperative urodynamic assessment available were excluded. Twenty-five patients were initially included in the study. Five patients were subsequently excluded, 2 because of incomplete
Urinary function
Four days after operation, the mean residual volume after micturation was 20 mL (range 0-40 mL), and the supra-pubic catheter was removed for all the patients on the fifth postoperative day.
Questionnaire results are listed in Table I and urodynamic results listed in Table II.Symptoms Preoperative n = 20 Postoperative n = 20 P value Difficulty emptying bladder 10% (n = 2) 10% (n = 2) ns Feeling of incomplete bladder
Discussion
The results of this prospective study confirm that TME can be performed with ANP for patients with rectal cancer confined to the mesorectum. Our aim was to study the best functional result achievable after anterior resection with TME, and we selected only patients with small tumors who did not require preoperative radiotherapy. None of our patients had direct lateral pelvic side wall involvement requiring nerve resection. Our stringent inclusion criteria explain the relatively small numbers in
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Reprint requests: Emmanuel Tiret, MD, Department of Surgery, Hôpital Saint-Antoine, 184 rue du faubourg Saint-Antoine, 75012 Paris, France.