The impact of the different modes of the preoperative radiotherapy following nerve sparing surgery on the urinary dysfunction in the patients with rectal cancer.
N.N.Petrov Research Oncology Iinstitute, St.-Petersburg
Purpose: Rectal cancer surgery is impaired with a high rate of postoperative urinary dysfunction cause with frequent autonomic nerve injuries. The aim of this study was prospective evaluation of urinary dysfunction in groups of patients after nerve sparing total mesorectal excision with/without preoperative radiotherapy.
Methods: One hundred eighty seven patients with adenocarcinoma of the rectum underwent autonomic nerve preserving surgery. The first group (n=40) underwent preoperative (long course (n= 18) or short course (n=22)) radiotherapy. The second group (n=147) was operated without any preoperative radiotherapy. Urinary function was assessed using the standardized questionnaire.
Results: The total preservation of pelvic autonomic nerves achieved in 73.5% patients in the group without radiotherapy, in 68.2% patients after short course and 38.9% patients after long course radiotherapy. The postoperative urinary dysfunction developed in 14.3%, 13.6%, and 33.3% patients respectively.
Conclusion: Our data show that the autonomic nerve identification and preservation depend of the method of preoperative radiotherapy. In groups of patients after short course preoperative radiotherapy and without preoperative radiotherapy it was shown an equal level of postoperative urinary dysfunction. In the group of patients after long course preoperative radiotherapy the level of urinary dysfunction was higher more than twice.
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