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It has been generally accepted that dysfunction, except a transient one, occurs little after surgery for colon cancer. Recently, it has been clarified what the lymph nodes ranging from the root of the inferior mesenteric artery to the superior rectal artery should be dissected on surgery for sigmoid colon cancer and since then, the dissection of this area was been performed as a routine operation. Such an extended dissection of the lymph nodes is likely to damage the hypogastric nerves lain immediately beneath the peritoneum anterior to and on either side of the aorta. The authors investigated urination and sexual function after surgery for sigmoid colon cancer. After the operations with extended lymph node dissection (R3-dissection difined by Japanease Research Society) were performed disturbance of male sexual function, especially disturbance of ejaculation, were observed in 46% of the patients. When the operations were performed with less extended lymph node dissection, male sexual dysfunction appeared only in 10% of the patients. Mild dysuria was seen in 21.6% of all the patients after operation for sigmoid colon cancer. No severe dysuria followed even after the R3 or less operative procedures. Accordingly, it is evident that preservation of the hypogastric nerves should be taken into consideration when the R3 or R2 lymph node dissection (R2-dissection difined by the role of Japanease Reserch Society) is performed. We recommended a method of operation for the preservation of the nerve.
日本大腸肛門病学会の論文

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