TY - JOUR
T1 - Dissection of the inferior mesenteric vein versus of the inferior mesenteric artery for the genitourinary function after laparoscopic approach of rectal cancer surgery
T2 - A randomized controlled trial
AU - Pallisera-Lloveras, Anna
AU - Planelles-Soler, Paula
AU - Hannaoui, Naim
AU - Mora-López, Laura
AU - Muñoz-Rodriguez, Jesús
AU - Serra-Pla, Sheila
AU - Dominguez-Garcia, Arturo
AU - Prats-López, Joan
AU - Navarro-Soto, Salvador
AU - Serra-Aracil, Xavier
AU - Hidalgo, Marta
AU - Del Pino, Carmen
AU - Macias, Ismael
AU - Ballesteros, Eva
AU - Casalots, Àlex
AU - Martinez-Bauer, Eva
N1 - Publisher Copyright:
© 2019 The Author(s).
PY - 2019/8/5
Y1 - 2019/8/5
N2 - Background: Total Mesorectal Excision (TME) is the standard surgical technique for the treatment of rectal cancer. However, rates of sexual dysfunction ofup to 50% have been described after TME, and rates of urinary dysfunction of up to 30%. Although other factors are involved, the main cause of postoperative genitourinary dysfunction is intraoperative injury to the pelvic autonomic nerves. The risk is particularly high in the inferior mesenteric artery (IMA). The aim of this study is to compare pre- and post-TME sexual dysfunction, depending on the surgical approach usedin the inferior mesenteric vessels: either directly on the IMA, or from the inferior mesenteric vein (IMV) to the IMA. Methods: Prospective, randomized,controlled study of patients with rectal adenocarcinoma with neoadjuvant chemoradiotherapy, who will be randomly assigned to one of two groups depending on the surgical approach to the inferior mesenteric vessels. The main variable is pre- and postoperative sexual dysfunction; secondary variables are visualization and preservation of the pelvic autonomic nerves, pre- and postoperative urinary dysfunction, and pre- and postoperative quality of life. The sample will comprise 90 patients, 45 per group. Discussion: The aim is to demonstrate that the dissection route from the IMV towards the IMA favors the preservation of the pelvic autonomic nerves and thus reducesrates of sexual dysfunction post-surgery. Trial registration: Ethical and Clinical Research Committee, Parc Taulí University Hospital: ID 017/315. ClinicalTrials.gov TAU-RECTALNERV-PRESERV-2018 (TRN: NCT03520088) (Date of registration 04/03/2018).
AB - Background: Total Mesorectal Excision (TME) is the standard surgical technique for the treatment of rectal cancer. However, rates of sexual dysfunction ofup to 50% have been described after TME, and rates of urinary dysfunction of up to 30%. Although other factors are involved, the main cause of postoperative genitourinary dysfunction is intraoperative injury to the pelvic autonomic nerves. The risk is particularly high in the inferior mesenteric artery (IMA). The aim of this study is to compare pre- and post-TME sexual dysfunction, depending on the surgical approach usedin the inferior mesenteric vessels: either directly on the IMA, or from the inferior mesenteric vein (IMV) to the IMA. Methods: Prospective, randomized,controlled study of patients with rectal adenocarcinoma with neoadjuvant chemoradiotherapy, who will be randomly assigned to one of two groups depending on the surgical approach to the inferior mesenteric vessels. The main variable is pre- and postoperative sexual dysfunction; secondary variables are visualization and preservation of the pelvic autonomic nerves, pre- and postoperative urinary dysfunction, and pre- and postoperative quality of life. The sample will comprise 90 patients, 45 per group. Discussion: The aim is to demonstrate that the dissection route from the IMV towards the IMA favors the preservation of the pelvic autonomic nerves and thus reducesrates of sexual dysfunction post-surgery. Trial registration: Ethical and Clinical Research Committee, Parc Taulí University Hospital: ID 017/315. ClinicalTrials.gov TAU-RECTALNERV-PRESERV-2018 (TRN: NCT03520088) (Date of registration 04/03/2018).
KW - Genitourinary dysfunction
KW - Injury to the pelvic autonomic nerves
KW - Rectal cancer
KW - Total Mesorectal excision
KW - Genitourinary dysfunction
KW - Injury to the pelvic autonomic nerves
KW - Rectal cancer
KW - Total Mesorectal excision
KW - Genitourinary dysfunction
KW - Injury to the pelvic autonomic nerves
KW - Rectal cancer
KW - Total Mesorectal excision
UR - http://www.scopus.com/inward/record.url?scp=85070361167&partnerID=8YFLogxK
U2 - 10.1186/s12894-019-0501-5
DO - 10.1186/s12894-019-0501-5
M3 - Article
C2 - 31382934
AN - SCOPUS:85070361167
SN - 1471-2490
VL - 19
JO - BMC Urology
JF - BMC Urology
IS - 1
M1 - 75
ER -