直腸癌に対する自律神経機能温存手術　第１報　自律神経を中心とした直腸癌手術分類の試み

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  • Autonomic Nerve Praserving Operation. A New Classification for the Operation of Rectal Cancer According to the Degrees of the Preserved Autonomic Nerve Plexus.
  • A New Classification for the Operation of Rectal Cancer According to the Degrees of the Preserved Autonomic Nerve Plexus
  • 第1報:自律神経を中心とした直腸癌手術分類の試み

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A hundred cases of rectal cancer were surgically treated from Junnuary 1982 to December 1990. These operations were classified as follows according to the degrees of preservation of autonomic nerve plexus.<BR>1a: No touch operation to both the superior hypogastric and pelvic plexus. (5 cases)<BR>1b: No touch operation to the pelvic plexus only. (26 cases)<BR>2a: Autonomic nerve preserving operation for the superior hypogastric and pelvic plexus. (2 cases)<BR>2b: Autonomic nerve preserving operarion for the pelvic plexus. (51 cases)<BR>3a: Radical excision of the superior hypogastric plexus and the only one-side pelvic plexus. (9 cases)<BR>3b: Radical excision of the superior hypogastric plexus and the bilateral pelvic plexus. (7 cases)<BR>Lymphatic metastasis (lateral spread) was seen 48 % (0%) in 1a+b, 43% (0.9%) in 2a+b and 44% (31%) in 3a+b. Postoperative urinary dysfunction was 0% in 1a+b and 2a, 65% in 2b, 86% in 3a and 100% in 3b. In 1a and 2a sexual distervance was not seen, and distervance of ejaculation was 100% in 1b, 2b and 3a+b, and distervance of erection was 20% in 2b and 100% in 3b. There was no significant difference in 5-year-survaival rate (64% in 1a+b, 75.6% in 2a+b, 67.5% in 3 a+b).

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