Objectives: To evaluate short-term effects of low anterior resection using
either open or laparoscopic approach on erectile function (EF) and sexual
performance of rectal cancer patients.
Patients & Methods: The study included 60 male patients with mean age
of 57.9±5.6 years; 45 had TO tumors, while 15 patients had Ti tumors
and 51 patients had NO and 9 patients had Ni nodal involvement. All
patients had low anterior rectal resection (RR) according to the standard
total mesorectal excision (TME) with identification of the hypogastric
and autonomic nerves using either laparoscopic (Lap RR) or open (Open
RR) approach. All patients underwent evaluation of EF using the
International Index of Erectile Function (IIEF-5) and sexual function and
performance using the Brief Male Sexual Function Inventory (BMSFI)
preoperatively and at 6 postoperative (PO) months.
Results: Mean operative time was significantly longer in Lap compared
to open RR. Mean intraoperative blood loss and need for blood
transfusion was significantly lower in Lap group and time till 1St flatus
passage, Pt oral fluid and solid food intake and PO hospital stay were
significantly shorter in Lap RR compared to Open RR. Eight patients
(13.3%) had wound related complications with significant difference in
favor of Lap group. Postoperative IIEF-5 scoring of total patients showed deterioration of EF manifested as significantly lower frequency of
patients had PO normal EF or even mild erectile dysfunction (ED)
compared to preoperative scoring with increased frequency of patients
had PO moderate and severe ED. Open procedure had more deleterious
effect on EF manifested as significantly lower frequency of patients had
PO normal EF or mild ED compared to preoperative scoring, while the
difference was non-significant in Lap group. All patients showed
deterioration of their sexual performance with significant difference
compared to their preoperative score. However, patients had Lap RR
showed significantly higher PO BMSFI scores compared those had open
RR |
