Potency, cure, and local control in the operative treatment of rectal cancer
W. E. Enker
Colorectal Service, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Impotence due to parasympathetic nerve injury is one of the most feared
consequences of operations for treatment of rectal cancer. Sharp dissection
along the parietal pelvic fascia where the parasympathetic nerves are
located significantly reduces the incidence of pelvic failure. Autonomic
nerve-preserving pelvic sidewall dissections, which combined the benefits
of en bloc parietal pelvic dissection with nerve preservation, were
performed in 42 men who were undergoing sphincter-preserving operations for
treatment of rectal cancer. Thirty-three (86.7%) of the 38 evaluable
patients have remained potent, and 29 (87.9%) of the 33 patients have
normal ejaculation. Deliberate sacrifice of the inferior hypogastric plexus
caused only minor sexual dysfunction. Cancer recurred locally in only one
patient (with stage D cancer). Autonomic nerve-preserving pelvic sidewall
dissection combines the benefits of curative resection and local control
with reduced morbidity, and it preserves potency.
Lateral Lymph Node Metastasis Is a Major Cause of Locoregional Recurrence in Rectal Cancer Treated with Preoperative Chemoradiotherapy and Curative Resection
Kim et al.
Ann. Surg. Oncol. 2008;15:729-737.
ABSTRACT
| FULL TEXT
Laparoscopic Pelvic Autonomic Nerve-Preserving Surgery for Patients with Lower Rectal Cancer after Chemoradiation Therapy
Liang et al.
Ann. Surg. Oncol. 2007;14:1285-1287.
ABSTRACT
| FULL TEXT
Thin-Section MRI with a Phased-Array Coil for Preoperative Evaluation of Pelvic Anatomy and Tumor Extent in Patients with Rectal Cancer
Akasu et al.
Am. J. Roentgenol. 2005;184:531-538.
ABSTRACT
| FULL TEXT
Clinical Nature and Prognosis of Locally Recurrent Rectal Cancer After Total Mesorectal Excision With or Without Preoperative Radiotherapy
van den Brink et al.
JCO 2004;22:3958-3964.
ABSTRACT
| FULL TEXT
A Simple Technique for Identification and Preservation of the Hypogastric Nerves During Rectal Surgery
Morpurgo et al.
Arch Surg 2004;139:1106-1109.
ABSTRACT
| FULL TEXT
Cost-Utility Analysis of Preoperative Radiotherapy in Patients With Rectal Cancer Undergoing Total Mesorectal Excision: A Study of the Dutch Colorectal Cancer Group
van den Brink et al.
JCO 2004;22:244-253.
ABSTRACT
| FULL TEXT
Perineal Dissection of Synchronous Abdominoperineal Resection of the Rectum: An Anatomical Description
Khatri et al.
Arch Surg 2003;138:553-559.
FULL TEXT
Surgery for colorectal cancer
Dorudi et al.
Br Med Bull 2002;64:101-118.
ABSTRACT
| FULL TEXT
Acute Side Effects and Complications After Short-Term Preoperative Radiotherapy Combined With Total Mesorectal Excision in Primary Rectal Cancer: Report of a Multicenter Randomized Trial
Marijnen et al.
JCO 2002;20:817-825.
ABSTRACT
| FULL TEXT
No Downstaging After Short-Term Preoperative Radiotherapy in Rectal Cancer Patients
Marijnen et al.
JCO 2001;19:1976-1984.
ABSTRACT
| FULL TEXT