直腸癌に対する自律神経温存術後の排尿機能の検討

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A time-related comparative study of urinary function following autonomic nerve preserving-procedure for rectal cancer was conducted by clinical symptoms and urodynamic study. Initial days of urinary sensory and autourination were estimated based on clinical data. In cases of complete autonomic nerve-preserving procedure, initial days were 7.7±2.3 and 8.5±2.2 days, respectively and 25.4±3.8 and 25.4±4.7 days in cases of unilateral S<SUB>4</SUB> pelvic nerve-preserving procedure. Eleven of the cases (84.6 %) who received done extended lymphonode dissection, required self-catheterization three months after surgery. In the cases of complete autonomic nerve-preserving and complete pelvic nerve-preserving procedure, urodynamic study performed three weeks postoperatively, revealed transient cystic pressure elevation and bladder compliance decrease at maximum urinary sensation. However, these symptoms had improved three months after surgery. Although retarded initial urinary sensation, elevated cystic pressure, decreased bladder compliance at primary and maximum urinary sensation, and decreased average and maximum urinary flow rates were recognized in cases of selective pelvic nervepreserving procedure, urinary function, including, urinary sensory and autourination, was sufficiently maintained. Urinary sensation and autourination were initiated slightly sooner in cases of sphincter-saving procedure than in cases of rectal amputation. Nevertheless, examination of urodynamic study revealed no differences between the two groups.
日本大腸肛門病学会の論文

直腸癌に対する自律神経温存術後の排尿機能の検討

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