Influence of Identification and Preservation of Pelvic Autonomic Nerves in Rectal Cancer Surgery on Bladder Dysfunction After Total Mesorectal Excision

• DOI: 10.1007/s10350-004-6621-2
• Publication Date: 2004-07-22T05:38:06Z
• Authors: T. Junginger; W. Kneist; A. Heintz
• Keywords: Urination; Colorectal Surgery; Autonomic nerve; Levator ani; Pudendal nerve

Given the improvement in oncologic outcome after introduction of total mesorectal excision for treatment rectal cancer, objective present study was to determine frequency identification and preservation pelvic autonomic nerves identify a possible link between postoperative micturition disturbances extent radical resection.Between March 1997 December 2001, 150 patients with adenocarcinoma rectum (<or=16 cm from anal verge) underwent surgery, sphincter 112 cases (74.7 percent). Sixty-three (42 percent) were classified as American Society Anesthesiologists Stage III two (1.3 IV. The number complete identification, partial or nonidentification (superior hypogastric plexus, nerve, inferior plexus) documented correlated (need long-term urinary catheter). Urine volumes measured by ultrasound before surgery.The identified completely 108 (72 percent), partially 16 (10.7 not at all 26 (17.3 After initial phase (n = 50 patients), realized 78 percent cases. Multivariate analysis showed that predetermined parameters (learning curve Group I vs. Groups II III, gender, T stage, blood loss, curative previous surgery), gender (P 0.006), learning 0.019), depth penetration wall (T1/T2 T3/T4; P 0.028) exerted an independent influence on achievement nerve identification. Sixteen discharged hospital catheter. Identification associated low bladder dysfunction rates (4.5 38.5 percent; < 0.001). In evaluation preoperative function, urologic history residual urine volume measurements essential. information obtained urodynamic studies no relevance.Identification achieved majority led prevention dysfunction. Gender stage are outcome.