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Abstract
Since the introduction of total mesorectal excision, clinical experience that has been reported widely, conclude that in comparison with conventionally practiced blunt surgery for rectal cancer, total mesorectal excision-based (i.e., anatomically correct, sharply performed) operations are associated with significantly lower rates of pelvic (local) recurrences, a significantly higher rate of survival, and significantly lower long-term morbidity. The latter is accomplished through dramatically higher rates of sphincter preservation, and the preservation of both sexual and urinary functions.
Urogenital dysfunction is a well recognized complication of rectal cancer surgery. It is important to assess the impact of autonomic nerve preservation and lateral node dissection on male urogenital function after total mesorectal excision for lower rectal cancer. The autonomic nerve preservation technique offers the great advantage of maintaining urogenital function after rectal cancer surgery. Although the autonomic nerve preservation technique minimized urinary dysfunction, sexual function, particularly ejaculation, was often damaged. Careful follow-up is important even after autonomic nerve preservation to improve postoperative sexual satisfaction.
There has been a dramatic improvement in surgical procedures for rectal cancer. Restorative resection with sphincter preservation has become possible for upper- and mid-rectal cancers because of a better understanding of the requisite distal resection margin. Technical improvements with the adoption of total mesorectal excision (TME), as advocated by Heald and Ryall has permitted a reduction in the local recurrence rate.