J.Jpn. Surg. Soc.
ISSN 1880-1129

[Abstract] [Full Text PDF] （in Japanese / 1608KB） [Members Only And Two Factor Auth.]

J.Jpn. Surg. Soc.. 101(6): 444-448, 2000

Feature topic

AUTONOMIC NERVE-SPARING SURGERY COMBINED WITH PHROPERATIVE RADIO-CHEMOTHERAPY IN ADVANCED LOWER RECTAL CANCER PATIENTS

1) Colorectal Surgery Division, National Cancer Center Hospital East, Kashiwa, Japan
2) Department of Surgery I, Chiba University School of Medicine, Chiba, Japan

Norio Saito1), Nobuhiro Takiguchi2), Keiji Koda2), Kenji Oda2), Kazuo Wakatsuki2), Nobuyuki Nakajima2)

Since 1985, we have studied autonomic nerve-sparing sutgery combined with preoperative radiochemotherapy in patients with advanced rectal cancer to preserve genitourinary function without compromising radicality. The aim of this study was to evaluate postoperative genitourinary function and prognosis. A total of 84 patients with advanced rectal cancer underwent curative surgery combined with preoperative radio-chemotherapy. Of them, 76 underwent curative nerve-sparing surgery using radiation (42.6Gy) and tegafur suppository. Postoperative genitourinary function, survival, and pelvic recurrence were investigated in these patients. The 5-year and 10-year disease-free survival rate was 80.7%, and the pelvic recurrence rate was 7.9% in patients receiving curative nerve-sparing surgery combined with radio-chemotherapy. All of these patients could micturate spontaneously, but preservation of sexual function was not as successful. Although this combined therapy is useful for curability and good postoperative quality of life, a new approach is needed to preserve sexual function.

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