Abstract:

Objective　To discuss the clinical application value and operative skills of conducting total mesorectal excision (TME) with pelvic autonomic nerve preservation（PANP） under the laparoscope for male patients, and provide reference for the radical resection of rectal carcinoma.　Method　According to retrospective study, 92 cases of male rectal carcinoma patients in our hospital were divided into 2 groups according to operation methods. 47 cases as the patients of the observation group are treated with TME with PANP under the laparoscope. 45 cases of the control group are treated with TME with PANP under the laparotomy. the operation-related index, sexual function, urination dysfunction and postoperative local recurrence of the patients in the two groups were compared.　Results　① intraoperative volume of blood loss, recovery time of postoperative intestines functions, time of postoperative recovery of eating and drinking, along with time of postoperative activity of the patients of the observation group are evidently lower than patients in the control group (P<0.05). While the whole operation time of the former group was longer than the latter group (P<0.05). There were not significant differences of incidence of postoperative complications between the two groups (P>0.05). ② the patients were followed up after their operations for one year. The occurrence rates of erectile dysfunction, and dysfunction of ejaculation and urination of the observation group patients were significantly lower than patients in  the control group（P<0.05）.There were not significant differences of local recurrence rate of the patients of the two groups one year after the operation（P>0.05）.　Conclusion　Performance of TME with PANP under the laparoscope is beneficial for the radical resection of rectal carcinoma. This method effectively reduces the influence on the urination and sexual function of the patients on the basis of radical treatment. So it is worthy of further promotion.

Key words: Colorectal cancer, Pelvic autonomic nerve preservation, Total mesorectal excision, Peritoneoscope