A study of outcomes in patients undergoing nerve preserving surgery in colorectal cancers

Authors

  • Sandeep Chandrakar Department of General Surgery, Pt. Jawaharlal Nehru Memorial Medical College and Dr B. R. Ambedkar Memorial Hospital, Raipur, Chhattisgarh, India
  • Rajendra Ratre Department of General Surgery, Pt. Jawaharlal Nehru Memorial Medical College and Dr B. R. Ambedkar Memorial Hospital, Raipur, Chhattisgarh, India
  • Ashutosh Gupta Department of Onco-Surgery, Pt. Jawaharlal Nehru Memorial Medical College and Dr B. R. Ambedkar Memorial Hospital, Raipur, Chhattisgarh, India
  • Harsh M. Agrawal Department of General Surgery, Pt. Jawaharlal Nehru Memorial Medical College and Dr B. R. Ambedkar Memorial Hospital, Raipur, Chhattisgarh, India
  • Avinash R. Department of General Surgery, Pt. Jawaharlal Nehru Memorial Medical College and Dr B. R. Ambedkar Memorial Hospital, Raipur, Chhattisgarh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20223591

Keywords:

Colorectal cancer, Nerve preserving surgery, Total mesorectal excision

Abstract

Background: Colorectal cancers are third most commonly diagnosed cancer globally. Its management consist mainly of surgical intervention to achieve an oncologic cure but also to preserve function. Introduction of nerve-preserving TME technique, spares the nerve and plexus pivotal for urinary and sexual function. The study assessed the urinary and sexual function after nerve sparing colorectal surgery. Aims and objective were to check functional outcomes after nerve preservation in patient undergoing colorectal cancer surgery, in terms of urinary and sexual function.

Methods: A prospective observational study conducted from January 2019 to July 2020, in the department of surgery and oncosurgery, Dr. BRAM Hospital, Raipur, Chhattisgarh.

Results: According to IPSS score, post-operatively, 57.5% showed fair urinary function, 22.5% showed good urinary function and 20% showed poor urinary function at 1 month. At 3 months, 80% showed good urinary function, 15% showed fair urinary function and 5% showed poor urinary function. According to IIEF score in males, post-operatively, at 1 month, 52% had a fair score, 40% had a poor score and 8% had a good score. At 3 months, 68% had a good score, 24% had a fair score and 8% had a poor score. According to FSFI score in females, post-operatively, at 1 month, 40% had a good score, 26.6% had fair score and 33.33% had a poor score. At 3 months, 66.67% had a good score, 13.33% had a fair score and 20% had a poor score.

Conclusions: Nerve preserving surgery in colorectal cancer significantly preserves urinary and sexual function.

 

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Author Biography

Sandeep Chandrakar, Department of General Surgery, Pt. Jawaharlal Nehru Memorial Medical College and Dr B. R. Ambedkar Memorial Hospital, Raipur, Chhattisgarh, India

department of surgery, resident doctor

References

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424.

Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, et al. Global cancer observatory: cancer today. Lyon, France: International Agency for Research on Cancer; 2018.

Rawla P, Sunkara T, Barsouk A. Epidemiology of colorectal cancer: incidence, mortality, survival, and risk factors. Przegla̜d Gastroenterol. 2019;14(2):89.

Lisfranc J. Memoir on the excision of the lower part of the rectum which has become carcinomatous. Me´m Acad R Chir. 1833;3:291-302.

Miles WE. A method of performing abdomino‐perineal excision for carcinoma of the rectum and of the terminal portion of the pelvic colon (1908). CA Cancer J Clin. 1971;21(6):361-4.

Hida J, Yasutomi M, Maruyama T, Fujimoto K, Uchida T, Okuno K. Lymph node metastases detected in the mesorectum distal to carcinoma of the rectum by the clearing method: justification of total mesorectal excision. J Am Coll Surg. 1997;184:584-8.

Chew MH, Yeh YT, Lim E, Seow-Choen F. Pelvic autonomic nerve preservation in radical rectal cancer surgery: changes in the past 3 decades. Gastroenterol Rep. 2016;4(3):173-85.

Heald RJ, Ryall RD. Recurrence and survival after total mesorectal excision for rectal cancer. Lancet. 1986;327(8496):1479-82.

Kim NK, Kim YW, Cho MS. Total mesorectal excision for rectal cancer with emphasis on pelvic autonomic nerve preservation: expert technical tips for robotic surgery. Surg Oncol. 2015;24(3):172-80.

Leveckis J, Boucher NR, Parys BT, Reed MW, Shorthouse AJ, Anderson JB. Bladder and erectile dysfunction before and after rectal surgery for cancer. Br J Urol. 1995;76(6):752-6.

Fowler JW, Bremner DN, Moffat LE. The incidence and consequences of damage to the parasympathetic nerve supply to the bladder after abdominoperineal resection of the rectum for carcinoma. Br J Urol. 1978;50(2):95-8.

Maas CP, Moriya Y, Steup WH, Kranenbarg EK, Van De Velde CJ. A prospective study on radical and nerve-preserving surgery for rectal cancer in the Netherlands. Eur J Surg Oncol. 2000;26(8):751-7.

Banerjee AK. Sexual dysfunction after surgery for rectal cancer. Lancet. 1999;353:1900-1.

Gwang-wook S. Anterior rectal mesenteric resection and autonomic nerve conservation. J Korean Soc Gastroenterol. 2006;47(4):254-9.

Dar MS, Parray FQ, Bhat AH, Chowdri NA, Wani ML. Impact of total mesorectal excision on bladder and sexual function in rectal cancer. Cancer Surg. 2016;2:110.

McSherry C, Cornell G, Glenn F. (1969) Carcinoma of the colon and rectum. Ann Surg. 1969;169:502-9.

Sterk P, Shekarriz B, Günter S, Nolde J, Keller R, Bruch HP, et al. Voiding and sexual dysfunction after deep rectal resection and total mesorectal excision. Int J Colorect Dis. 2005;20(5):423-7.

Vironen JH, Kairaluoma M, Aalto AM, Kellokumpu IH. Impact of functional results on quality of life after rectal cancer surgery. Dis Colon Rectum. 2006;49(5):568-78.

Majumdar SR, Fletcher RH, Evans AT. How does colorectal cancer present? Symptoms, duration, and clues to location. Am J Gastroenterol. 1999;94:3039-45.

Kim NK, Aahn TW, Park JK, Lee KY, Lee WH, Sohn SK, et al. Assessment of sexual and voiding function after total mesorectal excision with pelvic autonomic nerve preservation in males with rectal cancer. Dis Colon Rectum. 2002;45(9):1178-85.

Nesbakken A, Nygaard K, Bull-Njaa T, Carlsen E, Eri LM. Bladder and sexual dysfunction after mesorectal excision for rectal cancer. Br J Surg. 2000;87(2):206-10.

Liang JT, Lai HS, Lee PH, Chang KJ. Laparoscopic pelvic autonomic nerve-preserving surgery for sigmoid colon cancer. Ann Surg Oncol. 2008;15(6):1609-16.

Ameda K, Kakizaki H, Koyanagi T, Hirakawa K, Kusumi T, Hosokawa M. The long‐term voiding function and sexual function after pelvic nerve‐sparing radical surgery for rectal cancer. Int J Urol. 2005;12(3):256-63.

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Published

2022-12-30

How to Cite

Chandrakar, S., Ratre, R., Gupta, A., Agrawal, H. M., & R., A. (2022). A study of outcomes in patients undergoing nerve preserving surgery in colorectal cancers. International Surgery Journal, 10(1), 53–59. https://doi.org/10.18203/2349-2902.isj20223591

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Original Research Articles